PRIMARY CARE SURVEY 2014 - Ministry of Health · KEY FINDINGS FROM THE PRIMARY CARE SURVEY 2014...
Transcript of PRIMARY CARE SURVEY 2014 - Ministry of Health · KEY FINDINGS FROM THE PRIMARY CARE SURVEY 2014...
PRIMARY CARE SURVEY 2014
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CONTENTS
KEY FINDINGS FROM THE PRIMARY CARE SURVEY 2014 ....................................... i
Introduction ....................................................................................................... i Increase in Primary Care Utilisation ................................................................. i Improving Accessibility and Affordability of Primary Care .............................. ii Moving Ahead .................................................................................................. ii Concluding Remarks ....................................................................................... iii
CHAPTER 1 1
SURVEY BACKGROUND & OBJECTIVES .........................................................................1
Survey Background.......................................................................................... 1
Survey Objectives ............................................................................................ 1
CHAPTER 2 2
TARGET POPULATION, SAMPLE SELECTION, SURVEY FIELDWORK &
RESPONSE RATE ............................................................................................2
Target Population ............................................................................................. 2 Sample Selection ............................................................................................. 2
Survey Fieldwork ............................................................................................. 2 Response Rate ................................................................................................ 4 Survey Design Changes .................................................................................. 4 Sample Weight ................................................................................................. 5 Survey Result Presentation ............................................................................. 5
CHAPTER 3 6
MARKET SHARES IN PRIMARY CARE PROVISION BETWEEN PUBLIC AND
PRIVATE SECTORS ........................................................................................6
Shares of Overall Attendances ........................................................................ 6
Type of Visit ..................................................................................................... 7 Shares of Well and Sick Visits ......................................................................... 7
Disease Type ................................................................................................... 8 Shares of Acute and Chronic Visits ................................................................. 9
CHAPTER 4 10
MORBIDITY & BIOGRAPHIC PROFILE OF PATIENTS ............................................... 10
Demographic Profile ...................................................................................... 10 Leading Conditions ........................................................................................ 11
CHAPTER 5 17
BILL PAYMENT MODES ....................................................................................................... 17
Payment Modes ............................................................................................. 17
CHAPTER 6 21
CLINIC OPERATING & CARE MODEL ............................................................................. 21
A. Manpower Resource ....................................................................... 21
Primary Care Manpower by Sector ............................................................... 21
B. Workload of Doctors ........................................................................ 24
Clinical Hours Worked ................................................................................... 24 Number of Patients Attended Per Day .......................................................... 25
Workload of Resident GPs in Private GP Clinics .......................................... 25
C. Care Delivery ...................................................................................... 26
Estimated Length of Consultation Time ........................................................ 26
D. Accessibility of Clinics ................................................................... 27
Opening Hours of Private GP Clinics ............................................................ 27
Proximity of Residence to Clinic Visited ........................................................ 27
E. Medical Services for Homes and Nursing Homes ................ 28
Provision of Home Medical Services by Private GP Clinics ......................... 28
Provision of Medical Services for Nursing Homes by Private GP Clinics ..... 29
F. IT Capabilities and Deployment .................................................. 30
ANNEX A QUESTIONNAIRES ......................................................................................... 31
A-1: Questionnaire for Polyclinics.................................................................. 31 A-2: Questionnaire for Family Medicine Clinics ............................................ 47
A-3: Questionnaire for Private GP Clinics (Non-Medical Group) .................. 58 A-4: Questionnaire for Private GP Medical Groups ...................................... 72
i
KEY FINDINGS FROM THE PRIMARY CARE SURVEY 2014
Introduction
1. The Primary Care Survey (PCS) is a national survey conducted to collect
information of the primary care sector in Singapore. Its aim is to assess market
share in primary care provision between polyclinics and private general
practitioners (GP). PCS 2014, conducted between 22 September 2014 and 16
November 2014, was a cross-sectional survey on all 18 polyclinics, six Family
Medicine Clinics (FMCs) and a random sample of 522 private GP clinics
representative of the geographical zones of Singapore.
Increase in Primary Care Utilisation
2. Comparing single-day attendances across the survey years, the demand for
primary care appears to have increased. Between 2010 and 2014, surveyed
attendances increased by 1% each year (increase of around 5% in 2014
compared to 2010).
3. This increase was largely due to Singapore’s rapidly ageing population with
increasing chronic disease prevalence. More elderly had sought care at our
primary care providers i.e. polyclinics, GPs and FMCs in 2014, as compared to
2010. Out of the overall primary care attendances, the proportion of attendances
attributed to chronic disease management increased from 18% in 2010 to 27%
in 2014. This trend was observed in both polyclinics and private GP clinics.
Diabetes, Hypertension (high blood pressure), and Hyperlipidemia (high
cholesterol) were among the top chronic conditions seen at both polyclinics and
GP clinics.
4. Private GP clinics’ single-day surveyed attendances increased by 0.6% per
year (increase of around 3% in 2014 compared to 2010). Their casemix was
also observed to have changed. Based on the survey findings, GPs had seen
more elderly patients, with their proportion of patients who were 65 years and
above almost doubling from 6% in 2010 to 11% in 2014. They had also seen an
increase in patients with chronic conditions, from 12% of total attendances in
2010 to 20% in 2014.
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5. The polyclinics had similarly experienced an increase in single-day
surveyed attendances 1 ; at 3% per year (increase of around 13% in 2014
compared to 2010), despite the number of polyclinics remaining constant at 18
polyclinics. This was not surprising as 29% of patients in polyclinics were elderly
and 52% of their patients were patients with chronic conditions. Hence, the
utilization of polyclinics is expected to grow.
Improving Accessibility and Affordability of Primary Care
6. To cope with the growing need for primary care services, the Community
Health Assist Scheme (CHAS) was introduced in 2012 to improve accessibility
and affordability of primary care. Under CHAS, Singaporeans from lower- to
middle-income households can enjoy government subsidies when they seek
treatment at participating GP clinics for common illnesses, chronic diseases and
undergo recommended health screening, and at participating dental clinics for
selected dental procedures. With the introduction of the Pioneer Generation
Package (PGP) in September 2014, all Pioneers can also receive subsidies at
CHAS-registered GPs and dental clinics.
7. The PCS 2014 showed that an increasing number of Singaporeans are
benefitting from CHAS and PGP. In 2014, 10% of patients at GP clinics used
their CHAS subsidies. This was a significant increase from 2010 when less than
1% of patients at GP clinics enjoyed government subsidies under the Primary
Care Partnership Scheme (PCPS).2 Patients were also able to access care at
GP clinics conveniently, with the majority of them having to travel less than one
km to the clinics. Patients travelling more than 5km to visit polyclinics also
declined from 14% in 2010 to 12% in 2014.
Moving Ahead
8. Based on the PCS 2014 findings, private GP clinics served close to 80% of
the total primary care attendances and accounted for 80% of primary care doctor
manpower. The survey showed that CHAS at GP clinics has served us well,
enabling more patients to access affordable care with their regular family doctor
near their homes. Where necessary, GPs participating in CHAS are also able to
make subsidised referrals for their CHAS patients to Specialist Outpatient
1 These figures are cited for direct comparison with single-day surveyed data from private GPs. Based on annual polyclinic attendances data collected by MOH, polyclinic attendances grew by 8% from 2010 to 2014, at an annualised rate of 2% per year. 2 The PCPS was enhanced and re-named as CHAS in 2012.
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Clinics (SOCs) in the public hospitals. When their conditions stabilise, patients
can be referred back to their GPs for continued care in the community, nearer
their homes.
9. Given their significant market share, the GP sector should be supported to
play an increasing role in chronic disease management. Patients with chronic
diseases should be closely monitored by their regular family doctor, with an
increasing shift towards team-based approach for more holistic care. MOH will
continue to resource and equip GPs to do so. One initiative is through primary
care networks whereby GPs organise themselves into networks and pool
resources (such as nurse counsellors and primary care coordinators) and
ancillary services (such as Diabetic Foot Screening (DFS) and Diabetic Retinal
Photography (DRP)). This would facilitate team-based and holistic chronic care
management, particularly for solo GPs and also enable the GPs to achieve
economies of scale.
10. The PCS 2014 findings also reflected that the adoption of information
technology (IT) by GP clinics remained low with only 29% of them fully adopting
Electronic Medical Records (EMR) applications for patient records, and 40% of
GP clinics still using paper records. IT is an important enabler necessary to
integrate primary care with the rest of our healthcare system. The Ministry of
Health (MOH) will continue to work with GPs to enhance their IT adoption, and
to better support care delivery and clinic operations.
Concluding Remarks
11. With an ageing population and a rising chronic disease burden, our
healthcare system has to evolve to meet the needs of Singaporeans. Our
primary care providers are the first and continuous line of care for Singaporeans.
MOH will continue to invest in resources to develop and strengthen primary care
in Singapore.
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CHAPTER 1
SURVEY BACKGROUND & OBJECTIVES
Survey Background
1.1 The Primary Care Survey (PCS) 2014 was a cross-sectional survey on
licensed General Practitioner (GP) clinics in the public and private
sectors.
1.2 PCS 2014 was the sixth in its series. The earlier five surveys were
conducted in 1988, 1993, 2001, 2005 and 2010 respectively.
1.3 PCS 2014 was conducted by the Ministry of Health (MOH) between 22
September and 16 November 2014, with support from the College of
Family Physicians and the Singapore Medical Association.
Survey Objectives
1.4 The main survey objectives of PCS 2014 were to:
(a) study the market share in primary care provision between the public
and private sectors;
(b) gather the morbidity and biographic profile of patients seeking primary
care in the public and private sectors;
(c) draw insights from patients’ bill payment modes; and
(d) understand the operating and care model of primary care clinics in
terms of manpower, workload and consultation time, medical services for
home care and nursing homes provided by Private GP Clinics, and
Private GP Clinics’ IT capabilities and deployment.
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CHAPTER 2
TARGET POPULATION, SAMPLE SELECTION, SURVEY
FIELDWORK & RESPONSE RATE
Target Population
2.1 The target population was GP clinics licensed under the Private Hospitals
and Medical Clinics (PHMC) Act, with at least one practising GP.
Specialist clinics, dental clinics, dental mixed specialist clinics, charity
clinics, inaccessible clinics located in off-shore islands/ Changi Airport
Transit areas and clinics which see prisoners or lock-up cases were
excluded.
2.2 There were a total of 18 Polyclinics (9 polyclinics each under the National
Healthcare Group Polyclinics and SingHealth Polyclinics), 6 Family
Medicine Clinics (FMCs) and 1,406 Private GP Clinics in Singapore in
2014. The clinic manager of the polyclinics, FMCs and private GP clinics
were the target respondents.
Sample Selection
2.3 The survey covered all 18 polyclinics, 6 FMCs and a randomly selected
sample of 522 Private GP Clinics.
2.4 Proportionate stratified random sampling was used to select the 522
Private GP Clinics. The Private GP Clinics were first stratified by the 7
geographical zones of Singapore, namely Central, East, North,
Northeast, South, Southwest and West. The number of clinics selected
for each geographical zone was proportionate to the number of CHAS
(Community Health Assist Scheme) clinics and non-CHAS clinics in the
respective zones (Table 1). For each zone, systematic random sampling
was used to select the clinics.
Survey Fieldwork
2.5 The private GP Clinics were surveyed for one randomly-assigned day in
the week of 22 to 28 September 2014. Those clinics who were unable to
participate on the assigned survey day for various reasons (e.g. clinic
closed or clinic manager was away) were invited to take part on another
randomly-assigned day in the make-up week of 10 to 16 November 2014.
FMCs and polyclinics were surveyed for 1 week; from 22 to 28 September
2014 and from 29 September to 4 October 2014 respectively.
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Table 1: Geographical Distribution of Private GP Clinics in Population and Sample
Region
Population Sample
CHAS Non-CHAS CHAS Non-CHAS
Number Percent Number Percent Number Percent Number Percent
Central 168 28% 233 29% 64 28% 86 29%
East 120 20% 92 11% 44 20% 34 11%
North 57 10% 60 7% 22 10% 21 7%
Northeast 27 5% 11 1% 11 5% 4 1%
South 72 12% 234 29% 28 12% 87 29%
Southwest 52 9% 84 10% 20 9% 32 11%
West 94 16% 102 13% 35 16% 34 11%
Total 590 100% 816 100% 224 100% 298 100%
2.6 For Private GP Clinics, a notification letter informing on the survey was
sent to the clinic manager of the selected clinics about two weeks before
the assigned survey day. About 1 week before the survey day,
fieldworkers from QS-First Pte Ltd, an independent research firm
commissioned by MOH to undertake the fieldwork, contacted and visited
the clinics to brief them on the information required as well as how to fill
in the survey questionnaire. Instructions on how to fill in the survey
questionnaire and the survey questionnaire were then provided to the
clinic manager. Generally, the fieldworkers visited the clinics one week
after the assigned survey day to collect the completed questionnaires.
Clinics who expressed that they needed more time were given up to three
weeks to return the completed questionnaires to the fieldworkers.
2.7 For Polyclinics and Private GP Clinics from selected medical groups, the
questionnaires were sent to their Headquarters for co-ordination and
completion. The required patient data was generated from their
respective IT databases. The required survey data and completed
questionnaires, either in hardcopy or softcopy, were subsequently
collected or received by fieldworkers from QS-First Pte Ltd.
2.8 For FMCs, temporary staff recruited by MOH were deployed to the 6
clinics to undergo the necessary on-the-job training and thereafter
complete the questionnaires on patients who visited the clinics during the
survey week. The required survey data and completed questionnaires
were collected or received by fieldworkers from the research company.
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Response Rate
2.9 All 18 Polyclinics, all 6 FMCs and an eventual sample of 420 Private GP
Clinics in the private sector participated in the survey. Unlike the
Polyclinics and FMCs who provided full returns, some Private GP Clinics
submitted partial returns in which information on patients’ profile such as
demographics, diagnoses and mode of payment was not provded.
2.10 The overall response rate, including respondents with partial returns was
82.2%. The response rate of respondents with full returns was 56.3%
(Table 2). Table 3 shows the response rates of Private GP Clinics by
geographical zone.
Table 2: Overall Response Rates
Primary Care Provider
Target No.
No. Responded
Response Rate
All Returns (Full and partial )
Full Returns
Polyclinics 18 18 100.0% 100.0%
FMCs 6 6 100.0% 100.0%
Private GP Clinics^ 516 420 81.4% 54.3%
Total 540 444 82.2% 56.3%
^ 6 clinics out of 522 clinics were found to be ineligible during the fieldwork e.g. specialist clinics.
Table 3: Response Rates of Private GP Clinics
Survey Design Changes
2.11 In PCS 2005 and PCS 2010, all Polyclinics and Private GP Clinics in the
sample were surveyed on 1 day (a Wednesday) in September. In PCS
2014, the survey design was fine-tuned to enhance data robustness. All
Polyclinics were surveyed for 1 week starting in September (up from one
day) to capture day-of-the-week variations. FMCs which appeared for the
Geographical Zone
Target No.
No. Responded
Response Rate
All Returns (Full and partial )
Full Returns
Central 149 126 84.6% 60.4%
East 78 61 78.2% 46.2%
North 43 38 88.4% 65.1%
Northeast 15 15 100.0% 73.3%
South 110 82 74.5% 44.5%
Southwest 52 45 86.5% 61.5%
West 69 53 76.8% 49.3%
Total 516 420 81.4% 54.3%
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first time in PCS were similarly surveyed for 1 week starting in
September.
2.12 As a week-long survey would be too onerous on the Private GP Clinics
and likely result in lower response rates, clinics in the sample were
randomly assigned a day over a week (i.e. Monday, Tuesday, etc),
starting in September, to be surveyed on.
Sample Weight
2.13 This survey covered all 18 Polyclinics, all 6 FMCs and an eventual
sample of 420 Private GP Clinics. In the data analysis stage, sample
weighting was applied to the Private GP Clinics so that the findings for
the Private GP Clinics could be meaningfully extrapolated to the
population.
Survey Result Presentation
2.14 The Polyclinics and FMCs were surveyed for 1 week while the selected
Private GP Clinics were surveyed for 1 day across the week with different
clinics surveyed on different days of the week. To facilitate presentation
of survey results on Polyclinics, Private GP Clinics and FMCs on the
same time scale, the Polyclinic and FMC data was normalised to 1 day
using a factor of 5.5.
2.15 In the subsequent chapters, PCS 2014 survey results are presented
based on normalised 1-day data unless stated otherwise. For PCS 2005
and PCS 2010 where Polyclinics and Private GP Clinics were surveyed
for 1 day, their 1-day survey results were presented.
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CHAPTER 3
MARKET SHARES IN PRIMARY CARE PROVISION BETWEEN
PUBLIC AND PRIVATE SECTORS
3.1 This chapter provides information on the overall attendances, sick and well
visits, and acute and chronic visits at the Polyclinics and Private GP Clinics
which include FMCs in PCS 2014.
Shares of Overall Attendances
3.2 Table 4 shows the number of primary care clinic attendances (patient
attendances seen by doctor) by sector for the survey years.
Table 4: Overall Attendances by Sector
Annualised % change refers to the computed year-on-year percentage change between the survey years.
3.3 Chart 1 shows the market shares of overall attendances by sector. Private
GP Clinics continue to have the majority share of about 80% of the
attendances. Polyclinics’ share of attendances is about 20%.
Chart 1: Shares of Overall Attendances by Sector
^ Private GP Clinics include FMCs in 2014
2005 2010 2014^
22% 19% 21%
78% 81% 79%
Polyclinics Private GP Clinics
ALL Clinics Polyclinics Private GP Clinics
2005 2010 2014 2005 2010 2014~ 2005 2010 2014^
Number of attendances (1 survey day)
50,596 59,687 62,413 11,244 11,553 13,067 39,352 48,134 49,346
Annualised % change
- 3.4% 1.1% - 0.5% 3.1% - 4.1% 0.6%
Polyclinics and FMCs open for 5 ½ days per week.
~ 1-week survey data of Polyclinics is divided by 5.5 to obtain 1-day data.
^ Includes FMCs. 1-week survey data of FMCs is divided by 5.5 to obtain 1-day data and added to 1-day survey data of GPs.
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Type of Visit
3.4 Attendances at primary care clinics seen by doctor are classified into two
groups: “Sick” visits and “Well” visits based on principal diagnosis3.
i. “Sick” visits refer to visits made by patients who have medical
complaints.
ii. “Well” visits refer to visits made by patients who come for immunisation,
pre-employment medical check, preventive care for females,
developmental assessments for children, family planning visits, etc.
3.5 Chart 2 shows the distribution on type of visits by sector. Sick visits
continue to account for the majority of the total patient attendances.
However, the proportion of sick visits has dipped with a concomitant rise
in the proportion of well visits.
Chart 2: Distribution on Type of Visits by Sector
^ Private GP Clinics include FMCs in 2014
Shares of Well and Sick Visits
3.6 Private GP Clinics have the majority shares of well visits (about 90%) and
sick visits (about 80%) (Chart 3).
3 Principal diagnosis refers to the main reason for clinic visit.
2005 2010 2014 2005 2010 2014 2005 2010 2014^
All Clinics Polyclinics Private GP Clinics
8% 10% 13%6% 5% 9% 9% 11% 15%
92% 90% 87%94% 95% 91% 91% 89% 85%
Well Visit Sick Visit
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Chart 3: Shares of Type of Visits by Sector
^ Private GP Clinics include FMCs in 2014
Disease Type
3.7 The disease conditions of patients coming for “Sick” visits are further
classified into two categories: Acute and Chronic conditions.
i. “Acute” conditions refer to medical conditions with relatively rapid
onset, likely to be self-limiting and lasting for a short duration such as
upper respiratory tract infections, diarrhoeal diseases and sprains.
ii. “Chronic” conditions refer to medical conditions where the natural
history of the condition is likely to be long-standing and continuous or
episodic with recurrences that require regular follow ups and in
general, regular medications and management of risk factors.
Examples are hypertension, asthma and chronic obstructive lung
disease, diabetes and cancers.
3.8 The distribution on well visits, acute visits and chronic visits by sector is
shown in Chart 4. Acute visits continue to form the majority of the total
patient visits to all primary care clinics. However, the proportion of acute
visits has substantially declined between 2010 and 2014. Conversely, the
proportions of chronic and well visits to all clinics have noticeably
increased. The trend occurred in both Polyclinics and Private GP Clinics.
2005 2010 2014^ 2005 2010 2014^
Well Visit Sick Visit
15% 10% 14%23% 20% 22%
85% 90% 86%77% 80% 78%
Polyclinics Private GP Clinics
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Chart 4: Distribution on Attendances* by Disease Type by Sector
* Attendances were classified based on principal diagnosis ^ Private GP Clinics include FMCs in 2014
Percentages may not add to 100% due to rounding for some years
Shares of Acute and Chronic Visits
3.9 The shares of acute visits and chronic visits by sector are shown in Chart 5.
Private GP Clinics had the majority shares of acute visits (about 90%) and
chronic visits (about 60%).
Chart 5: Shares of Attendances^ by Disease Type by Sector
* Attendances were classified based on principal diagnosis ^ Private GP Clinics include FMCs in 2014
2005 2010 2014 2005 2010 2014 2005 2010 2014^
All Clinics Polyclinics Private GP Clinics
8% 10% 13%6% 5% 9% 9% 11% 15%
20% 18%
27% 38% 40%
52%
15% 12%20%
72% 73%60% 56% 54%
40%
76% 77%65%
Well Visit Chronic Visit Acute Visit
2005 2010 2014 2005 2010 2014^
Chronic Visit Acute Visit
42% 45% 41%
17% 14% 14%
58% 55% 59%
83% 86% 86%
Polyclinics Private GP Clinics
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CHAPTER 4
MORBIDITY & BIOGRAPHIC PROFILE OF PATIENTS
4.1 This chapter provides information on the profile of patients visiting
Polyclinics and Private GP Clinics which include FMCs in 2014.
Demographic Profile
4.2 The demographic profile of patients (in terms of gender, race, age, house
type and residential status) who sought primary care is presented in
Table 5.
Table 5: Demographic Profile of Patients by Sector
ALL Clinics
Polyclinics Private
GP Clinics
2005 2010 2014 2005 2010 2014 2005 2010 2014^
Gender
Male 47% 49% 49% 49% 49% 50% 47% 49% 48%
Female 53% 51% 51% 51% 51% 50% 53% 51% 52%
Race
Chinese 70% 67% 67% 67% 64% 70% 70% 68% 65%
Malay 14% 13% 12% 17% 19% 16% 14% 12% 11%
Indian 9% 10% 10% 11% 11% 9% 8% 10% 11%
Others 7% 10% 11% 5% 6% 5% 8% 11% 13%
Age (years)
0-4 5% 5% 5% 6% 5% 7% 5% 4% 3%
5-19 13% 11% 8% 14% 12% 7% 13% 11% 8%
20-39 38% 41% 36% 22% 20% 17% 42% 46% 43%
40-64 33% 34% 36% 36% 40% 40% 32% 32% 35%
65 & above 11% 10% 15% 21% 22% 29% 8% 6% 11%
House Type
HDB 1-3 room 22% 21% 29% 26% 26% 32% 21% 19% 24%
HDB 4-5 room/ multi-generation/ executive/ HUDC
58% 60% 63% 61% 61% 63% 57% 60% 63%
Private apartment/ house
16% 17% 7% 8% 12% 5% 19% 18% 11%
Others 4% 2% 1% 5% 1% 1% 3% 2% 2%
Residential Status
Singapore citizens/ PRs
87% 81% 81% 93% 93% 96% 85% 78% 76%
Foreigners working/ living in Singapore
12% 16% 18% 7% 6% 4% 13% 19% 22%
Foreigners not working/ living in Singapore
1% 3% 1% 1% 0.2% 0% 2% 3% 2%
^ Private GP Clinics include FMCs in 2014
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4.3 Polyclinics had a higher proportion of elderly patients, compared to Private
GP Clinics. Private GP Clinics had a higher proportion of adult patients
aged 20 to 39 years old, compared to Polyclinics in 2014. In addition,
Polyclinics had a higher proportion of patients living in HDB 1-3 room flats
whilst Private GP Clinics had a higher proportion of patients residing in
private apartment/house. Private GP Clinics also had a higher proportion
of patients who were foreigners working or living in Singapore.
Leading Conditions
4.4 This section presents the diagnoses of the disease conditions for which
medical attention was being sought, including both sick and well visits.
Findings are presented for both the principal diagnosis, as well as for all
diagnoses.
Leading Conditions in 2014 (Principal Diagnosis & All Diagnoses)
4.5 Upper respiratory tract infections (URTI) which constituted 24% of all
principal diagnosis and 20% of all diagnoses, was the top leading condition
in 2014. In a distant second position were musculoskeletal, soft tissue &
joint conditions at 7% of all principal diagnosis and hypertension at 9% of
all diagnoses (Table 6).
4.6 For Polyclinics, Diabetes was the leading principal diagnosis at 13%
whereas for all diagnoses, Hyperlipidemia was the most common condition
(Table 7).
4.7 For Private GP Clinics, URTI was ranked top for principal diagnosis and
for all diagnoses (Table 8).
Table 6: Top 10 Leading Conditions in 2014 – All Clinics
Principal Diagnosis All Diagnoses
Rank Disease/ Conditions % Rank Disease/ Conditions %
1 URTI 24% 1 URTI 20%
2 Musculoskeletal, soft tissue & joint conditions (Include SLE)
7% 2 Hypertension, essential, benign 9%
3 Hypertension, essential, benign 6% 3 Musculoskeletal, soft tissue & joint conditions
7%
4 Infectious conditions (exclude HIV, dengue, chicken pox)
6% 4 Hyperlipidemia 7%
5 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
4% 5 Infectious conditions (exclude HIV, dengue, chicken pox)
5%
6 Dermatological conditions 4% 6 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
4%
7 Injuries & Trauma (exclude factures & foreign bodies)
3% 7 Dermatological conditions 4%
8 Gastritis & peptic ulcer diseases 2% 8 Injuries & Trauma (exclude factures & foreign bodies)
2%
9 Eye & eyelid structural conditions 2% 9 Gastritis & peptic ulcer diseases 2%
10 Hyperlipidemia 2% 10 Eye & eyelid structural conditions 2%
Other disease conditions 40% Other disease conditions 38%
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Table 7: Top 10 Leading Conditions in 2014 – Polyclinics
Principal Diagnosis All Diagnoses
Rank Disease/ Conditions % Rank Disease/ Conditions %
1 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
13% 1 Hyperlipidemia 15%
2 Hypertension, essential, benign 12% 2 Hypertension, essential, benign 15%
3 URTI 10% 3 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
9%
4 Musculoskeletal, soft tissue & joint conditions (include SLE)
7% 4 URTI 6%
5 Hyperlipidemia 4% 5 Musculoskeletal, soft tissue & joint conditions (include SLE)
6%
6 Infectious conditions (exclude HIV, dengue, chicken pox)
4% 6 Infectious conditions (exclude HIV, dengue, chicken pox)
3%
7 Injuries & Trauma (exclude factures & foreign bodies)
2% 7 Ischaemic heart disease, IHD 2%
8 Dermatological conditions 2% 8 Renal conditions 2%
9 Neonatal jaundice, NNU 1% 9 Injuries & Trauma (exclude factures & foreign bodies)
2%
10 Asthma & acute bronchitis 1% 10 Dermatological conditions 1%
Other disease/ conditions 44% Other disease/ conditions 39%
Table 8: Top 10 Leading Conditions in 2014 – Private GP Clinics^
Principal Diagnosis All Diagnoses
Rank Disease/ Conditions % Rank Disease/ Conditions %
1 URTI 29% 1 URTI 25%
2 Infectious conditions (exclude HIV, dengue, chicken pox)
7% 2 Musculoskeletal, soft tissue & joint conditions (include SLE)
7%
3 Musculoskeletal, soft tissue & joint conditions
7% 3 Infectious conditions (exclude HIV, dengue, chicken pox)
6%
4 Dermatological conditions 5% 4 Hypertension, essential, benign 6%
5 Hypertension, essential, benign 5% 5 Dermatological conditions 5%
6 Injuries & Trauma (exclude factures & foreign bodies)
3% 6 Hyperlipidemia 3%
7 Gastritis & peptic ulcer diseases 2% 7 Injuries & Trauma (exclude factures & foreign bodies)
2%
8 Eye & eyelid structural conditions 2% 8 Gastritis & peptic ulcer diseases 2%
9 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
2% 9 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
2%
10 Neurological conditions (exclude CVA, stroke & TIA)
1% 10 Eye & eyelid structural conditions 2%
Other disease/ conditions 37% Other disease/ conditions 40%
^ Private GP Clinics include FMCs in 2014
13
Leading Conditions in 2014 & 2010 (Principal Diagnosis)
4.8 Tables 9 to 11 below present the comparative figures of the top 10
leading diseases/conditions in Singapore based on principal diagnosis.
URTI, accounting for 24% of all principal diagnosis in 2014 and 29% in
2010, remained the most dominant disease/condition (Table 9).
Table 9: Top 10 Leading Conditions (Principal Diagnosis) in 2014 & 2010 – All Clinics
ALL Clinics in 2014 ALL Clinics in 2010
Rank Principal Diagnosis % Rank Principal Diagnosis %
1 URTI 24% 1 URTI 29%
2 Musculoskeletal, soft tissue & joint conditions (Include SLE)
7% 2 Hypertension, essential, benign 7%
3 Hypertension, essential, benign 6% 3 Musculoskeletal, Soft Tissue & Joint Conditions (Include SLE)
5%
4 Infectious conditions (exclude HIV, dengue, chicken pox)
6% 4 Diarrhoeal Diseases 5%
5 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
4% 5 Dermatological conditions 5%
6 Dermatological conditions 4% 6 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
5%
7 Injuries & Trauma (exclude factures & foreign bodies)
3% 7 Injuries & Trauma (exclude factures & foreign bodies)
3%
8 Gastritis & peptic ulcer diseases 2% 8 Gastritis & peptic ulcer diseases 3%
9 Eye & eyelid structural conditions 2% 9 Fever & Pyrexia of unknown origin (PUO) 2%
10 Hyperlipidemia 2% 10 Other gastro-intestinal conditions 2%
Table 10: Top 10 Leading Conditions (Principal Diagnosis) in 2014 & 2010 – Polyclinics
Polyclinics in 2014 Polyclinics in 2010
Rank Principal Diagnosis % Rank Principal Diagnosis %
1 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
13% 1 URTI 20%
2 Hypertension, essential, benign 12% 2 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
16%
3 URTI 10% 3 Hypertension, essential, benign 15%
4 Musculoskeletal, soft tissue & joint conditions (include SLE)
7% 4 Musculoskeletal, soft tissue & joint conditions (include SLE)
6%
5 Hyperlipidemia 4% 5 Hyperlipidemia 4%
6 Infectious conditions (exclude HIV, dengue, chicken pox)
4% 6 Dermatological conditions 4%
7 Injuries & Trauma (exclude factures & foreign bodies)
2% 7 Diarrhoeal Diseases 3%
8 Dermatological conditions 2% 8 Injuries & Trauma (exclude factures & foreign bodies)
3%
9 Neonatal jaundice, NNU 1% 9 Eye & eyelid structural conditions 2%
10 Asthma & acute bronchitis 1% 10 Gastritis & peptic ulcer diseases 2%
14
Table 11: Top 10 Leading Conditions (Principal Diagnosis) in 2014 & 2010 – Private GP Clinics
Private GP Clinics in 2014^ Private GP Clinics in 2010
Rank Principal Diagnosis % Rank Principal Diagnosis %
1 URTI 29% 1 URTI 32%
2 Infectious conditions (exclude HIV, dengue, chicken pox)
7% 2 Diarrhoeal Diseases 6%
3 Musculoskeletal, soft tissue & joint conditions
7% 3 Dermatological conditions 5%
4 Dermatological conditions 5% 4 Musculoskeletal, soft tissue & joint conditions (include SLE)
5%
5 Hypertension, essential, benign 5% 5 Hypertension, essential, benign 5%
6 Injuries & Trauma (exclude factures & foreign bodies)
3% 6 Injuries & Trauma 3%
7 Gastritis & peptic ulcer diseases 2% 7 Gastritis & peptic ulcer diseases 3%
8 Eye & eyelid structural conditions 2% 8 Fever & Pyrexia of unknown origin (PUO) 2%
9 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
2% 9 Other gastro-intestinal conditions 2%
10 Neurological conditions (exclude CVA, stroke & TIA)
1% 10 Eye & eyelid structural conditions 2%
^ Private GP Clinics include FMCs in 2014
Leading Conditions in 2014 & 2010 (All Diagnoses)
4.9 Tables 12 to 14 below present the comparative figures of the top 10
leading disease conditions in Singapore based on all diagnoses. The top
4 leading conditions in 2010 remained unchanged in 2014 (Table 12).
Table 12: Top 10 Leading Conditions (All Diagnoses) in 2014 & 2010 – All Clinics
ALL Clinics in 2014 ALL Clinics in 2010
Rank All Diagnoses % Rank All Diagnoses %
1 URTI 20% 1 URTI 25%
2 Hypertension, essential, benign 9% 2 Hypertension, essential, benign 8%
3 Musculoskeletal, soft tissue & joint conditions
7% 3 Hyperlipidemia 6%
4 Hyperlipidemia 7% 4 Musculoskeletal, Soft Tissue & Joint Conditions (Include SLE)
5%
5 Infectious conditions (exclude HIV, dengue, chicken pox)
5% 5 Dermatological conditions 5%
6 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
4% 6 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
4%
7 Dermatological conditions 4% 7 Diarrhoeal Diseases 4%
8 Injuries & Trauma (exclude factures & foreign bodies)
2% 8 Gastritis & peptic ulcer diseases 3%
9 Gastritis & peptic ulcer diseases 2% 9 Injuries & Trauma (exclude factures & foreign bodies)
3%
10 Eye & eyelid structural conditions 2% 10 Eye & eyelid structural conditions 2%
15
Table 13: Top 10 Leading Conditions (All Diagnoses) in 2014 & 2010 – Polyclinics
Polyclinics in 2014 Polyclinics in 2010
Rank All Diagnoses % Rank All Diagnoses %
1 Hyperlipidemia 15% 1 Hyperlipidemia 17%
2 Hypertension, essential, benign 15% 2 Hypertension, essential, benign 15%
3 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
9% 3 URTI 12%
4 URTI 6% 4 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
10%
5 Musculoskeletal, soft tissue & joint conditions (include SLE)
6% 5 Musculoskeletal, soft tissue & joint conditions (include SLE)
5%
6 Infectious conditions (exclude HIV, dengue, chicken pox)
3% 6 Dermatological conditions 3%
7 Ischaemic heart disease, IHD 2% 7 Ischaemic heart disease, IHD 3%
8 Renal conditions 2% 8 Diarrhoeal Diseases 2%
9 Injuries & Trauma (exclude factures & foreign bodies)
2% 9 Renal conditions 2%
10 Dermatological conditions 1% 10 Injuries & Trauma (exclude factures & foreign bodies)
2%
Table 14: Top 10 Leading Conditions (All Diagnoses) in 2014 & 2010 – Private GP Clinics
Private GP Clinics in 2014^ Private GP Clinics in 2010
Rank All Diagnoses % Rank All Diagnoses %
1 URTI 25% 1 URTI 29%
2 Musculoskeletal, soft tissue & joint conditions (include SLE)
7% 2 Dermatological conditions 6%
3 Infectious conditions (exclude HIV, dengue, chicken pox)
6% 3 Hypertension, essential, benign 6%
4 Hypertension, essential, benign 6% 4 Musculoskeletal, soft tissue & joint conditions (include SLE)
5%
5 Dermatological conditions 5% 5 Diarrhoeal Diseases 5%
6 Hyperlipidemia 3% 6 Gastritis & peptic ulcer diseases 3%
7 Injuries & Trauma (exclude factures & foreign bodies)
2% 7 Injuries & Trauma 3%
8 Gastritis & peptic ulcer diseases 2% 8 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
2%
9 Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
2% 9 Hyperlipidemia 2%
10 Eye & eyelid structural conditions 2% 10 Fever & Pyrexia of unknown origin (PUO) 2%
^ Private GP Clinics include FMCs in 2014
16
Leading Acute and Chronic Conditions in 2014 (Principal Diagnosis)
4.10 URTI was the top acute condition seen in both Polyclinics and Private GP
Clinics. The 2 leading acute conditions seen in Polyclinics were the same as
that seen in Private GP Clinics. (Table 15).
4.11 Diabetes was the top chronic condition seen at Polyclinics, while it ranks 3rd
for Private GP Clinics. Musculoskeletal, soft tissue & joint conditions was the
top chronic condition for Private GP Clinics. Hypertension was the 2nd
leading chronic condition seen at both Polyclinics and Private GP Clinics
(Table 16).
Table 15: Top 10 Acute Conditions (Principal Diagnosis) in 2014
Polyclinics Private GP Clinics^
Rank Principal Diagnosis % Rank Principal Diagnosis %
1 (1) URTI 30% 1 (1) URTI 44%
2 Infectious conditions (exclude HIV, dengue, chicken pox)
9% 2 Infectious conditions (exclude HIV, dengue, chicken pox)
11%
3 (5) Injuries & Trauma (exclude factures & foreign bodies)
7% 3 (3) Dermatological conditions 6%
4 (2) Musculoskeletal, soft tissue & joint conditions (include SLE)
6% 4 (5) Injuries & Trauma (exclude factures & foreign bodies)
4%
5 (3) Dermatological conditions 5% 5 (9) Eye & Eye Lid Structural Conditions 3%
6 (8) Neonatal jaundice, NNJ 5% 6 (6) Gastritis & Peptic Ulcer Diseases 3%
7 Complication of surgical care 4% 7 Asthma & Acute Bronchitis 2%
8 Asthma & Acute Bronchitis 3% 8 (7) Fever & Pyrexia of Unknown Origin (PUO) 2%
9 (10) Other Respiratory Conditions 2% 9 Renal Conditions 2%
10 (7) Gastritis & peptic ulcer diseases 2% 10 (4) Musculoskeletal, soft tissue & joint conditions (include SLE)
2%
^ Private GP Clinics include FMCs in 2014. Numbers in brackets refer to 2010 ranking.
Table 16: Top 10 Chronic Conditions (Principal Diagnosis) in 2014
Polyclinics Private GP Clinics^
Rank Principal Diagnosis % Rank Principal Diagnosis %
1 (1) Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
32% 1 (5) Musculoskeletal, soft tissue & joint conditions (include SLE)
28%
2 (2) Hypertension, essential, benign 30% 2 (1) Hypertension, essential, benign 23%
3 (6) Musculoskeletal, soft tissue & joint conditions (include SLE)
11% 3 (2) Diabetes (Exclude DM Neuropathy/ Nephropathy & Venous Ulcers, Include Other Cx)
8%
4 (3) Hyperlipidemia 10% 4 Dermatological conditions 8%
5 Infectious conditions (exclude HIV, dengue, chicken pox)
3% 5 (3) Hyperlipidemia 5%
6 Vision Problems (Exclude Cataract & Glaucoma)
2% 6 Neurological Conditions (Exclude CVA, Stroke & TIA)
5%
7 (5) Ischaemic Heart Disease, IHD 1% 7 Gastritis & Peptic Ulcer Diseases 3%
8 (7) Hypothyroidism 1% 8 (7) Psychiatric Conditions 3%
9 Gastritis & Peptic Ulcer Diseases 1% 9 Colorectal & Perianal Conditions 2%
10 Gynaecological Conditions (Exclude Fibroids)
1% 10 Eye & Eye Lid Structural Conditions 1%
^ Private GP Clinics include FMCs in 2014. Numbers in brackets refer to 2010 ranking.
17
CHAPTER 5
BILL PAYMENT MODES
5.1 This chapter provides information on the various modes of bill payment by
patients who visited Polyclinics and the Private GP Clinics for primary care
consultation.
Payment Modes
5.2 The payment modes for Polyclinic and Private GP Clinic patients are
classified differently.
5.3 For Polyclinic patients, the payment modes are as follows:
i. “Government subsidy for Singapore citizens and Permanent
Residents” which includes subsidy for patients who hold the Pioneer
Generation (PG) card;
ii. “Civil Service Benefits” for patients who are covered under their Civil
Service employment, including retired civil servants (pensioners)
and their dependants;
iii. “SAF Personnel” for patients who are covered under SAF;
iv. “Baby Bonus CDA” which refers to payment using Baby Bonus
Development Account;
v. “Medisave (Own)” which refers to withdrawal from patient’s
Medisave to pay for approved treatment;
vi. “Medisave (Family)” which refers to withdrawal from patient’s family
member‘s Medisave to pay for approved treatment;
vii. “Cash Out of Pocket” which refers to all payment made in cash by
patient (include patients who are required to make cash co-payment
after other forms of payment have been deducted i.e. Civil Service
Benefits, SAF Personnel, Baby Bonus CDA, Medisave); and
viii. “Others” which includes partial or full waivers for blood donors and
patients on Public Assistance Scheme.
18
5.4 For Private GP Clinic patients, the payment modes are:
i. “CHAS Subsidy” which refers to subsidy for patients who hold the
Blue or Orange Community Health Assist Scheme (CHAS) or
Pioneer Generation (PG) or Public Assistance cards(s);
ii. “Insurance Company” which refers to payment made directly by
insurance company for patient’s personal or employer insurance;
iii. “Company Contract” which refers to payment made directly by
patient’s company (does not include patients who enjoy corporate
rates but are required to pay upfront and seek reimbursement on
their own);
iv. ““Baby Bonus CDA” which refers to payment using Baby Bonus
Development Account;
v. “MBS@Gov” which refers to payment made directly by PSD for
patients who are civil servants (does not include cash co-payment
made by patients);
vi. “Medisave (Own)” which refers to withdrawal from patient’s
Medisave to pay for approved treatment;
vii. “Medisave (Family)” which refers to withdrawal from patient’s family
member‘s Medisave to pay for approved treatment; and
viii. “Cash Out of Pocket” which refers to all payment made in cash by
patient (include patients who are required to pay upfront and seek
reimbursement on their own from insurance company / employer,
and those required to make cash co-payment after other forms of
payment have been deducted / subsidies have been applied i.e.
CHAS subsidy, insurance company and company contract payment,
MBS@Gov, Baby Bonus CDA, Medisave).
19
5.5 Chart 6 shows the payment modes of Polyclinic patients. Patients could
incur 1 or more modes of payment. For example, a patient who is a
Singapore citizen or Permanent Resident and qualifies for government
subsidy would use it to offset his/her bill. The patient could also tap on
his/her Medisave for partial bill payment and finally use some cash out of
pocket as a co-payment to settle the remaining bill balance. In 2014, 9 in
10 patients (92%) made use of government subsidy. 1 in 7 patients (14%)
tapped on Medisave, more than doubled from the 6% proportion in 2010.
There was a declining proportion of patients who used cash out-of-pocket
as payment/co-payment for their bills over the survey years; dropping from
85% in 2005 to 79% in 2014.
Chart 6: Payment Modes of Polyclinic Patients
~ For Singapore citizens and Permanent Residents (captured for the first time in 2014) * 2005 and 2010: Included Baby Bonus CDA which could not be differentiated from cash payment over the two surveys
Government
Subsidy~
Cash Out of
Pocket*
Civil Service
& SAF
Personnel
Benefits
MediSave Baby Bonus
CDA
Others
85%
11%4%
82%
8%6% 8%
92%
79%
9% 14%
1% 3%
2005 2010 2014
20
5.6 Chart 7 shows the payment modes of Private GP Clinic patients. Similar
to Polyclinic patients, Private GP Clinic patients could incur 1 or more
modes of payment. The proportion of patients who used cash out of pocket
as payment/co-payment for their bills dropped from 75% in 2005 to 59%
in 2014. 10% of patients tapped on CHAS subsidy in 2014, higher than
the proportion of 0.4% who tapped on PCPS in 2010. The proportion
drawing payments from insurance companies also increased from 7% in
2010 to 11% in 2014, while those seen on company contract fell from 27%
in 2010 to 24% in 2014. The proportion who tapped on Medisave for
payment remained relatively insignificant at less than 1%.
Chart 7: Payment Modes of Private GP Clinic Patients
PCPS: Primary Care Partnership Scheme, CHAS: Community Health Assistance Scheme ~ 2005 and 2010: Included Baby Bonus CDA and MBS@Gov which could not be differentiated from cash
payment over the two surveys ^ Private GP Clinics include FMCs in 2014
Cash Out
of Pocket~
Company
Contract
Insurance
Company
PCPS/CHAS
Subsidy
MediSave Baby
Bonus CDA
MBS@Gov
75%
20%
6%
67%
27%
7%0.4% 0.7%
59%
24%
11% 10%
0.3%3.0% 1.0%
2005 2010 2014^
21
CHAPTER 6
CLINIC OPERATING & CARE MODEL
6.1 This chapter presents information on manpower resource, workload of
doctors, care delivery, accessibility of clinics, provision of medical
services to resident homes and nursing homes and use of information
technology (IT).
A. Manpower Resource
Primary Care Manpower by Sector
Shares of All GPs by Sector – Headcount
6.2 GPs in Singapore predominantly practised in Private Clinics, accounting
for 82% of doctors in all clinics in 2014. This proportion has declined,
compared to 2010 (87%) and 2005 (88%) (Chart 8).
Chart 8: Distribution of Primary Care Manpower~ by Sector (All GPs)
~ Refers to GPs who worked on one survey day ^ Private GP Clinics include FMCs in 2014
Shares of Resident GPs (excluding Locums, Residents/Trainees) by Sector –
Headcount
6.3 Resident GPs in Singapore mostly practised in Private Clinics,
comprising 84% of resident doctors in all clinics in 2014. This proportion
had dipped, compared to 2010 (87%) and 2005 (88%) (Chart 9).
2005 2010 2014^
12% 13%18%
88% 87%82%
Polyclinics Private GP Clinics
22
Chart 9: Shares of Primary Care Manpower~ by Sector (Resident GPs)
~ Refers to GPs who worked on one survey day ^ Private GP Clinics include FMCs in 2014
Distribution of Resident GPs, Locum GPs and Residents/Trainees – Headcount
6.4 The proportion of resident GPs by headcount progressively declined over
the survey years with a concomitant rise in the proportion of locum GPs.
The decline in proportion of resident GPs was seen in both Private GP
Clinics and Polyclinics, and was markedly evident in the Polyclinics in
2014 (down to 69% from 88% in 2010). In 2014, data on
residents/trainees under the residency programme was collected for the
first time. Residents/trainees made up 18% of the manpower headcount
in Polyclinics in 2014, more than locum GPs which comprised 13% of the
headcount (Chart 10).
Chart 10: Distribution of Resident GPs~, Locum GPs~ and Residents/Trainees~ By Sector
~ Refer to GPs who worked on one survey day. For PCS 2014, data on residents/trainees was collected separately from resident GPs and locum GPs. The residency programme for residents/trainees began in 2011 and no data on residents/trainees was available for earlier surveys.
2005 2010 2014^
12% 13% 16%
88% 87% 84%
Polyclinics Private GP Clinics
2005 2010 2014 2005 2010 2014 2005 2010 2014^
All Clinics Polyclinics Private GP Clinics
91% 87% 81%89% 88%
69%
91% 87% 84%
9% 13%16%
11% 12%
13%
9% 13% 16%3%
18%
Resident GP Locum GP Resident/Trainee
23
^ Private GP Clinics include FMCs in 2014
Private GP Clinics: Distribution of FTE GPs
6.5 A higher proportion of Private GP Clinics (47%) had less than 1 Full-Time
Equivalent 4 (FTE) GPs working in their clinic in 2014, compared to
previous survey years (23% in 2005 and 26% in 2010). Correspondingly,
a lower proportion of Private GP Clinics (48%) had 1 to less than 2 FTE
GPs in 2014, compared to 67% in 2005 and 2010. The average number
of FTE GPs fell from 1.3 in 2010 to 1.1 in 2014 although the median
number remained the same (Table 17).
Table 17: Distribution of All FTE Private GPs
Number of FTE GPs
Private GP Clinics
2005 2010 2014^
< 1 23% 26% 47%
1 to < 2 67% 67% 48%
2 to < 3 7% 4% 2%
3 to < 4 1% 2% 1%
4 to < 5 1% 0.3% 1%
5 or more 0.6% 0.6% 0.7%
Mean 1.3 1.3 1.1
Median 1.1 1.1 1.1
^ Private GP Clinics Include FMCs for 2014
4 Number of FTE GPs = Sum of hours worked in a week by all GPs in the clinic divided by 42 hours
24
B. Workload of Doctors
Clinical Hours Worked
6.6 In Private GP clinics, majority or close to one-third of the resident GPs (31%)
worked over 16 to 32 clinical hours per week in 2014, with significant
proportions working longer hours, including 19% who worked over 48
hours. In Polyclinics, half of the resident GPs (46%) worked over 40 to 48
hours per week, while another one-third (31%) worked over 16 to 32 clinical
hours. A higher proportion of them worked shorter hours of over 16 to 32
hours now; from 15% in 2010 to 31% in 2014. On average, resident GPs in
Polyclinics worked 33.5 clinical hours per week in 2014, down from 38.7
hours in 2010 and 39.9 hours in 20055. Resident GPs in Private GP clinics
worked on average 37.5 clinical hours per week, up from 33.2 hours in 2010
(Table 18).
Table 18: Clinical Hours Worked Per Week of Resident GPs by Sector
Clinical Hours Worked Per Week
Polyclinics Private
GP Clinics
2005 2010 2014 2005 2010 2014^
1-8 hours -- 2% 3% 8% 14% 1%
Over 8 to 16 hours -- -- 5% 7% 7% 1%
Over 16 to 32 hours 12% 15% 31% 18% 21% 31%
Over 32 to 40 hours -- 3% 15% 19% 18% 17%
Over 40 to 48 hours 88% 81% 46% 30% 23% 31%
Over 48 hours 0.4% -- -- 18% 17% 19%
Mean (hours) 39.9 38.7 33.5 36.1 33.2 37.5 ^ Private GP Clinics Include FMCs for 2014
6.7 Table 19 shows the range of working hours served by Locum GPs by sector. Generally, locums in Private GP Clinics worked longer clinical hours with 56% of them working over 16 to 32 hours in 2014. In contrast, locums in Polyclinics worked shorter clinical hours with 46% working 16 hours and below. On average, Locum GPs in Private GP clinics worked 28.6 hours per week while those in Polyclinics worked 20.2 hours per week.
Table 19: Clinical Hours Worked Per Week of Locum GPs by Sector
Clinical Hours Worked Per Week
Polyclinics Private
GP Clinics
2005 2010 2014 2005 2010 2014^
1-8 hours 30% 12% 29% 62% 73% 3%
Over 8 to 16 hours 20% 3% 17% 23% 18% 10%
Over 16 to 32 hours 30% 35% 32% 7% 7% 56%
Over 32 to 40 hours 7% 9% 6% 3% 2% 7%
Over 40 to 48 hours 13% 41% 16% 1% 1% 17%
Over 48 hours -- -- -- 4% -- 7%
Mean (hours) 19.6 30.6 20.2 11.3 7.8 28.6 ^ Private GP Clinics Include FMCs for 2014
5 The clinical hours worked excludes hours spent on administrative duties, training and research.
25
39
57
30
48
30
58
Private GP
Clinics^
Polyclinics
2005 2010 2014
Number of Patients Attended Per Day
6.8 A FTE GP6 in Polyclinics attended to a higher number of patients per day
(57) in 2014, compared to his counterpart in Private GP Clinics (39)
(Chart 11).
Chart 11: Number of Patients Attended Per Day by a FTE GP by Sector
^ Private GP Clinics Include FMCs for 2014
Workload of Resident GPs in Private GP Clinics
6.9 Table 20 shows the patient load and working hours of Resident GPs
working in Private GP Clinics.
Table 20: Private Resident GPs’ Workload and Working Hours
Description 2005 2010 2014^
(i) Number of patients seen on survey day
• Median
• Mean (standard deviation)
23.0
26.9 (17.8)
25.0
28.3 (20.2)
25.2
24.2 (12.6)
(ii) Number of clinical hours worked on
survey day
• Median
• Mean (standard deviation)
7.0
6.7 (2.3)
7.0
6.9 (2.4)
7.0
6.3 (2.6)
^ Private GP Clinics Include FMCs for 2014
6 1 FTE GP is equivalent to 1 GP who has worked 7.5 hours per day
26
C. Care Delivery
Estimated Length of Consultation Time
6.10 GPs providing primary care generally spent longer consultation time on
chronic cases relative to acute cases. On average, GPs in Private GP
Clinics spent longer consultation time7 with their patients than those
working in Polyclinics, regardless of acute or chronic cases (Chart 12).
Chart 12: Estimated Length of Consultation Time by Disease Type by Sector
^ Private GP Clinics Include FMCs for 2014
7 Consultation time is based on the estimated average consultation time of patients seen for acute and chronic
conditions respectively, and provided on a per-clinic basis.
100%
27% 31%
16%24%
4% 4% 5%
100% 100%
58% 54%
50%
76%
72%
89%
30%19%
23%
15% 15%
34%28%
11%
66%77%
72%
5 mins or less 6 - 10 mins Over 10 mins
ACUTE Cases CHRONIC Cases
Mean time --
(mins)
4.3 7.5 8.9 8.8 8.8 10.4 2005 2010 2014 2005 2010 2014^
Polyclinics Private GP Clinics
6.8 10.2 10.0 15.2 16.6 15.8 2005 2010 2014 2005 2010 2014^
Polyclinics Private GP Clinics
27
D. Accessibility of Clinics
Opening Hours of Private GP Clinics
6.11 Among Private GP Clinics that opened 50 hours or less a week, an
increasing proportion of them tended to operate shorter number of
opening hours. The median number of opening hours declined from 47
hours in 2010 to 44 hours in 2014 (Table 21).
Table 21: Opening Hours (Per Week) of Private GP Clinics
Opening Hours Per Week
Private GP Clinics
2005 2010 2014^
Less than 30 hours 6% 8% 13%
Over 30 to 40 hours 16% 17% 23%
Over 40 to 45 hours 21% 19% 17%
Over 45 to 50 hours 24% 22% 12%
Over 50 to 60 hours 18% 19% 19%
Over 60 hours 15% 14% 15%
Mean (hours) 50.0 49.0 48.0
Median (hours) 47.0 47.0 44.0 ^ Private GP Clinics Include FMCs for 2014
Proximity of Residence to Clinic Visited
6.12 This section provides information on the distance of patients’ homes to
the clinics they visited. Distance was calculated using the postal codes of
the residential addresses8 of the patients as provided by the clinics.
6.13 Foreigners neither working nor living in Singapore, and patients staying
in non-residential addresses and patients whose postal codes were not
available or invalid were excluded from analysis.
6.14 Private GP Clinics had the highest proportion (51%) of patients who lived
within 1km or less, relative to Polyclinics (31%) in 2014. Polyclinics had
the lowest proportion of patients (12%) who lived over 5 km away. The
trends were similar in 2010 and 2005 (Table 22).
Table 22: Distribution of Patients by Distance to Clinic Visited and Sector
Distance to Clinic Polyclinics
Private GP Clinics
2005 2010 2014 2005 2010 2014^
1 km or less 31% 31% 31% 53% 51% 51%
Over 1 km to 5 km 55% 56% 57% 24% 28% 25%
Over 5 km 15% 14% 12% 23% 22% 24% ^ Private GP Clinics Include FMCs for 2014
8 Note: Distance was calculated based on residential postal codes of patients to the clinic postal codes, hence
there is a limitation as patients may or may not have travelled to the clinic from their residence.
28
E. Medical Services for Homes and Nursing Homes
Provision of Home Medical Services by Private GP Clinics
6.15 Half of the Private GP Clinics (51%) indicated that they provided home
medical services in 2014 (Chart 13). Up to 98% of Private GP Clinics which
provided home medical services charged for the services. Up to 14%
provided the service on a pro-bono basis (whereby all charges were waived,
including consult and drugs) (Chart 14).
Chart 13: Proportion of Private GP Clinics
Providing Home Medical Services
Chart 14: Home Medical Services by Private GP Clinics
(Payable or Pro-bono), 2014
85.2%
13.4%
1.4%
Payable Payable or Pro-bono Pro-bono
54%
37%
51%
2005 2010 2014
29
Provision of Medical Services for Nursing Homes by Private GP Clinics
6.16 1 in 10 Private GP Clinics (10%) reported that they provided medical services
for nursing homes in 2014. Of those who did so, up to 96% charged for the
services and up to 23% provided the services free of charge (Chart 15).
Chart 15: Medical Services for Nursing Homes by Private GP Clinics
(Payable or Pro-bono), 2014
77%
4%19%
Payable Pro-bono Payable or pro bono
30
F. IT Capabilities and Deployment
6.17 As a whole, 4 in 10 Private GP Clinics (40%) maintained patient medical
records using Paper Cards. 3 in 10 (29%) maintained patient records using
Electronic Medical Record (EMR) applications such as Clinic Assist,
Medi2000, Gloco, CLEO and Clinic Manager. 3 in 10 (31%) used both. (Table
23).
Table 23: Paper and Electronic Maintenance
of Patient Medical Records, 2014
Type of Patient Medical Records All GP Clinics
Paper cards only 40%
EMR^ only 29%
Paper and EMR 31%
100%
^ Electronic Medical Records (EMR) applications such as Clinic Assist, Medi2000, Gloco, CLEO, Clinic Manager, InfoCare, freeware, shareware of GP self-developed software
31
ANNEX A QUESTIONNAIRES
A-1: Questionnaire for Polyclinics For Office Use
SECTION A : PARTICULARS OF POLYCLINIC
Name of Polyclinic :
Name of Contact Person :
Contact Number :
SECTION B : INFORMATION ON CLINIC PRACTICE
1. What is the estimated shortest, longest and average consultation time for acute and chronic
cases seen by your clinic doctors?
Consultation Time Shortest
mins per
case
Longest
mins per
case
Average
mins per
case
a. Acute case refer to cases with short onset such as upper respiratory
tract infections, diarrhoeal diseases, sprains.
b. Chronic case refer to conditions that requires long term follow-up and in
general, regular medications and management of risk
factors. Examples are hypertension, asthma and chronic
obstructive lung disease, diabetes & cancers.
2. On average, what is the number of hours your clinic is open per week?
hours per week
PRIMARY CARE SURVEY 2014
- Polyclinics -
Clinic ID :
CHAS: Yes / No
CDMP: Yes / No
32
3. Does your clinic provide the following services? If yes, please indicate with a tick whether it is conducted
(a) within your clinic and by whom; and/or (b) outsourced. Please specify which institution(s) the service
is outsourced to.
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
I. Diagnostic Test
Doctor Nurse
Allied
Health
a. Blood test for fasting glucose and fasting lipids
1 2 3 4 5
b. On-site Haemoglobin A1c (HbA1c) test
1 2 3 4 5
c. Hepatitis A & B (Adult)
1 2 3 4 5
d. HIV screening
1 2 3 4 5
e. Nephropathy assessment
1 2 3 4 5
f. Pap smear taking
1 2 3 4 5
g. Renal function – creatinine and/or eGFR
1 2 3 4 5
h. Serum cholesterol level (LDL-C) test
1 2 3 4 5
i. Urine dipstick test
1 2 3 4 5
j. Urine protein – urine protein: creatinine ratio
1 2 3 4 5
33
II. Clinical Assessment/ Physical Examination
a. Ankle Brachial Index
1 2 3 4 5
b. Asthma Control Test (ACT)
1 2 3 4 5
c. Clinical thromboembolism risk assessment
1 2 3 4 5
d. Diabetic retinal photography
1 2 3 4 5
e. Elderly functional assessment
1 2 3 4 5
f. Eye assessment
1 2 3 4 5
g. Foot assessment
1 2 3 4 5
h. Hearing test
1 2 3 4 5
i. Smoking cessation programme
1 2 3 4 5
j. Spirometry
1 2 3 4 5
III. Assessment using the following scales:
a. Assessment of memory (MMSE or CMMSE
testing or other validated instruments)
1 2 3 4 5
b. Clinical Global Impression (CGI) Scale
1 2 3 4 5
34
c. International Prostate Symptom Score (I-PSS)
1 2 3 4 5
d. Schawb and England Activities of Daily Living
Scale
1 2 3 4
e. Unified Parkinson’s Disease Rating Scale (falls)
1 2 3 4 5
IV. Vaccination
a. Childhood vaccination
1 2 3 4 5
b. Influenza vaccination
1 2 3 4 5
c. Travel Vaccination
1 2 3 4 5
V. Education & Counselling
a. Education & Counselling to promote self-
care
1 2 3 4 5
b. Family Planning advice
1 2 3 4 5
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
VI. Allied Health Services
Doctor Nurse
Allied
Health
a. Dietetic counselling services
1 2 3 4 5
b. Occupational therapy services
1 2 3 4 5
35
c. Physiotherapy services
1 2 3 4 5
d. Podiatry services
1 2 3 4 5
e. Speech therapy services
1 2 3 4 5
VII. Procedures
a. Ear syringing
1 2 3 4 5
b. Incision and drainage
1 2 3 4 5
c. Intralesional injection for trigger finger
1 2 3 4 5
d. IUCD insertion and removal
1 2 3 4 5
e. Nail avulsion / Wedge resection
1 2 3 4 5
f. Naso-gastric tube insertion
1 2 3 4 5
g. Relieve of subungal haematoma
1 2 3 4 5
h. Urinary catheterisation
1 2 3 4 5
i. Wound desloughing and removal of foreign body
1 2 3 4 5
j. Wound dressing
1 2 3 4 5
36
VIII. Other procedure(s) and service(s), please specify:
a.
2 3 4 5
b.
2 3 4 5
c.
2 3 4 5
d.
2 3 4 5
e.
2 3 4 5
f.
2 3 4 5
g.
2 3 4 5
h.
2 3 4 5
i.
2 3 4 5
j.
2 3 4 5
37
4. Please provide the following information for ALL doctors who perform clinical work in your clinic during the survey week.
(Exclude (a) doctors who are doing only administrative work (b) Specialists and (c) Dentists)
cont’d on next page
S/N of
Doctor
Doctor MCR
no.
(Doctor MCR
no. to
correspond to
Doctor MCR
No. provided
in Section C)
Resident physician*1,
Locum doctor*2 Or
Resident/Trainee*3 of Clinic
TICK ONE BOX
Scheduled No.
of Clinical
Hours to work
during the
Survey Week
(in hrs)
Actual No. of Clinical Hours worked on each day of the Survey Week
(in hrs)
Resident
physician
Locum
doctor
Resident/
Trainee
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
01. 1
2
3
02. 1
2
3
03. 1
2
3
04. 1
2
3
05. 1
2
3
06. 1
2
3
07. 1
2
3
08. 1
2
3
09. 1
2
3
10. 1
2
3
*1 Resident physicians refer to doctors who are permanently employed in your clinic, including those who work on fixed days in a week or on rotational basis to various clinics in the
same group and MOPEX MOs.
*2 Locum doctors refer to doctors who are on non-permanent employment, typically called in to supplement/ substitute/ stand in temporarily for the resident physicians.
*3 Residents/Trainees refer to doctors on the residency programme or on training.
38
cont’d on next page
S/N of
Doctor
Doctor MCR
No.
(Doctor MCR
no. to
correspond to
Doctor MCR
No. provided in
Section C)
Resident physician*1,
Locum doctor*2 Or
Resident/Trainee*3 of Clinic
TICK ONE BOX
Scheduled No.
of Clinical
Hours to work
during the
Survey Week
(in hrs)
Actual No. of Clinical Hours worked on each day of the Survey Week
(in hrs)
Resident
physician
Locum
doctor
Resident/
Trainee
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
11. 1
2
3
12. 1
2
3
13. 1
2
3
14. 1
2
3
15. 1
2
3
16. 1
2
3
17. 1
2
3
18. 1
2
3
19. 1
2
3
20. 1
2
3
21. 1
2
3
22. 1
2
3
23. 1
2
3
24. 1
2
3
25. 1
2
3
39
S/N of
Doctor
Doctor MCR
No.
(Doctor MCR
no. to
correspond to
Doctor MCR
No. provided in
Section C)
Resident physician*1,
Locum doctor*2 Or
Resident/Trainee*3 of Clinic
TICK ONE BOX
Scheduled No.
of Clinical
Hours to work
during the
Survey Week
(in hrs)
Actual No. of Clinical Hours worked on each day of the Survey Week
(in hrs)
Resident
physician
Locum
doctor
Resident/
Trainee
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
26. 1
2
3
27. 1
2
3
28. 1
2
3
29. 1
2
3
30. 1
2
3
31. 1
2
3
32. 1
2
3
33. 1
2
3
34. 1
2
3
35. 1
2
3
36. 1
2
3
37. 1
2
3
38. 1
2
3
39. 1
2
3
40. 1
2
3
40
5. Please provide the following information for ALL Nurses who perform clinical work in your clinic during the survey week.
(Exclude Nurses who are doing only administrative work outside of clinical setting.)
cont’d on next page
S/N of
Nurse
Registered Nurse, Enrolled Nurse,
Advanced Practice Nurse Or Registered
Midwife
TICK ALL THAT APPLIES
Scheduled No.
of Hours to
work during
the Survey
Week
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Registered
Nurse
Enrolled
Nurse
Advanced
Practice
Nurse
Registered
Midwife
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
01. 1
2
3
4
02. 1
2
3
4
03. 1
2
3
4
04. 1
2
3
4
05. 1
2
3
4
06. 1
2
3
4
07. 1
2
3
4
08. 1
2
3
4
09. 1
2
3
4
10. 1
2
3
4
41
S/N of
Nurse
Registered Nurse, Enrolled Nurse,
Advanced Practice Nurse Or Registered
Midwife
TICK ALL THAT APPLIES
Scheduled No.
of Hours to
work during
the Survey
Week
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Registered
Nurse
Enrolled
Nurse
Advanced
Practice
Nurse
Registered
Midwife
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
11. 1
2
3
4
12. 1
2
3
4
13. 1
2
3
4
14. 1
2
3
4
15. 1
2
3
4
16. 1
2
3
4
17. 1
2
3
4
18. 1
2
3
4
19. 1
2
3
4
20. 1
2
3
4
21. 1
2
3
4
22. 1
2
3
4
23. 1
2
3
4
24. 1
2
3
4
25. 1
2
3
4
42
6. Please provide the following information for ALL Allied Health Professionals (AHPs) who perform clinical work in your clinic during the survey week.
(Exclude AHPs who are doing only administrative work outside of clinical setting.)
cont’d on next page
S/N of
AHP
Registered Allied Health Professionals
Please fill in the job title in the box below
Scheduled No.
of Hours to
work during
the Survey
Week
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Occupational
Therapy*1
(or Ergomedicine or
Ergotherapy)
Physiotherapy*2
Speech-Language
Pathology*3
(Speech Language
Pathology)
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
*1 Occupational Therapist, Ergotherapist
*2 Physiotherapist, Physical Therapist
*3 Speech Language Therapist (or Speech-Language Therapist), Speech Language Pathologist (or Speech-Language Pathologist), Speech and Language Therapist (or Speech-and-Language
Therapist), Speech and Language Pathologist (or Speech-and-Language Pathologist), Speech Therapist (or Speech-Therapist), Speech Pathologist (or Speech-Pathologist)
43
S/N of
AHP
Registered Allied Health Professionals
Please fill in the job title in the box below
Scheduled No.
of Hours to
work during
the Survey
Week
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Occupational
Therapy*1
(or Ergomedicine or
Ergotherapy)
Physiotherapy*2
Speech-Language
Pathology*3
(Speech Language
Pathology)
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
44
SECTION C: PATIENTS’ PROFILE
1. For Section C, please provide the following information listed below for all patients who visit your clinic on EACH day of the survey
week in softcopy Excel format. Please include patients seen by GPs, Nurses and Allied Health Professionals in your clinic but exclude
patients seen by Specialists and Dentists. The explanations on the data items required and the codes to be used are provided
below. For e.g. for Race, the codes to be used are: 1=Chinese, 2=Malay, 3=Indian, 4= Others, 8=Unknown.
2. Please provide the information in accordance to the sequence specified below.
Data Items Required Explanations/ Code To Use
a. Date of Survey Please provide the date in DDMMYYYY format e.g. 22092014
b. Name of Clinic Please provide name of clinic e.g. ABC Clinic
c. Address of Clinic Please provide address of clinic e.g. 123, ABC Road, #05-06
d. Postal Code of Clinic Please provide postal code of clinic e.g. 654123
I. Patient Profile
a. Queue No / Registration No Please provide Queue No / Registration No. of patient (This number
uniquely identifies the patient. Please do not provide patient's NRIC)
b. Year of Birth This is a 4-digit field e.g. 1945, 2001
c. Sex 1=Male
2=Female
8=Unknown
d. Race 1=Chinese
2=Malay
3=Indian
4=Others
8=Unknown
e. Residential Status 1=Singapore Citizen/PR (i.e. patients with NRIC starting with S or T)
2=Foreigner Working/Living in Singapore (i.e. patients with FIN starting
with F or G)
3=Others
8=Unknown
f. House Unit Number
(#xx-___ )
Pls fill in Unit No. if available. For any address without ‘#” (S’pore Landed
property), pls fill in ‘0’
For patients not living in S’pore, pls fill in ‘999999’ and if address is
unknown, pls fill in ‘888888’
g. Road Name Pls specify only for those living in S’pore Landed Property
h. Postal Code For patients living in S’pore HDB/Pte Apt/Condo, please fill in the 6-digit
postal code.
For those living in S’pore Landed Property, please fill in only the first 2
digits of the 6-digit postal code.
For patients not living in Singapore, please fill in '999999' and if address is
unknown, please fill in '888888'
II. Doctor Consult
a. Doctor Serial No. or MCR no.
(Please use same MCR no. as in Section B, Q4) Please provide Doctor Code (This code uniquely identifies the doctor
e.g. MCR No, System Generated Doctor Code)
b. Doctor Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
c. Doctor Diagnosis (Up to 5)
Doctor Principal Diagnosis Code Please provide Principal Diagnosis and Principal Diagnosis Code
Doctor Other Diagnosis 1 Code Please provide Other Diagnosis 1 and Other Diagnosis 1 Code
Doctor Other Diagnosis 2 Code Please provide Other Diagnosis 2 and Other Diagnosis 2 Code
Doctor Other Diagnosis 3 Code Please provide Other Diagnosis 3 and Other Diagnosis 3 Code
Doctor Other Diagnosis 4 Code Please provide Other Diagnosis 4 and Other Diagnosis 4 Code
45
Data Items Required Explanations/ Code To Use
d. Medical Certificate (MC) issued? 1=Yes 2=No
If yes, how many days? No. of days
III. Nurse Consult
a. Nurse Serial No.
(Please use same S/N no. as in Section B, Q5)
Please provide Nurse Code
b. Nurse Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
c. Nurse Procedures (Up to 4)
Nurse Procedure 1 Please provide Procedure 1
Nurse Procedure 2 Please provide Procedure 2
Nurse Procedure 3 Please provide Procedure 3
Nurse Procedure 4 Please provide Procedure 4
IV. AHP Consult
a. AHP Serial No.
(Please use same S/N no. as in Section B, Q6)
Please provide AHP Code
b. AHP Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
c. AHP Procedures (Up to 4)
AHP Procedure 1 Please provide Procedure 1
AHP Procedure 2 Please provide Procedure 2
AHP Procedure 3 Please provide Procedure 3
AHP Procedure 4 Please provide Procedure 4
V. Bill and Payment Information
a. Mode of Payment
1. Government subsidy for Singapore Citizens $ and Permanent Residents*1 $ 2. Civil Service Benefits*2 $ 3. SAF Personnel*3 $ 4. Baby Bonus CDA accounts*4 $ 5. Medisave (Own)*5 $ 6. Medisave (Family)*6 $ 7. Cash out of Pocket*7 (received by Polyclinic) $ 8. Others*8 $ 9. Total Bill (Summation of Items 1 to 8) $
b. Bill Size Components
[To fill in $ amount of components as shown in the patient’s
bill. The $ amount should (i) exclude GST; and (ii) before
deduction of any form of payment, waiver of fees or
subsidies]
1. Consultation Fees $
2. Medication/ Drugs $
3. Laboratory/ Diagnostic Tests $
4. Procedures
(To itemise the procedures if available from the bill)
$
i. $
ii. $
iii. $
iv. $
5. Others $
6. Total Bill (Summation of Items 1 to 5) $
46
Footnotes:
*1 Government subsidy for Singapore
Citizens and Permanent Residents:
Includes subsidy for patients who hold the following cards: Blue or Orange Community Health Assist
Scheme (CHAS) or Pioneer Generation card(s). *2 Civil Service Benefits: Patients who are covered under their Civil Service employment, including retired civil servants
(pensioners) and their dependants.
*3 SAF Personnel: Patients who are covered under SAF.
*4 Baby Bonus CDA accounts: Payment using Baby Bonus Child Development Account.
*5 Medisave (Own): Amount withdrawn from patient’s Medisave to pay for approved treatment.
*6 Medisave (Family): Amount withdrawn from patient family member’s Medisave to pay for approved treatment.
*7 Cash out of Pocket: All payment made in cash by patient. Include patients who are required to make cash co-payment after
other forms of payments have been used (i.e. Baby Bonus CDA, Medisave, Civil Service Benefits, SAF
personnel).
*8 Others: Include partial or full waivers for blood donors and patients on Public Assistance Scheme.
47
A-2: Questionnaire for Family Medicine Clinics
For Office Use
SECTION A: INFORMATION ON CLINIC PRACTICE
1. What is the estimated shortest, longest and average consultation time for acute and chronic cases seen by your
clinic doctors?
Consultation Time Shortest
mins per case
Longest
mins per case
Average
mins per case
a. Acute case refer to cases with short onset such as upper respiratory tract
infections, diarrhoeal diseases, sprains.
b. Chronic case refer to conditions that requires long term follow-up and in
general, regular medications and management of risk factors.
Examples are hypertension, asthma and chronic obstructive
lung disease, diabetes & cancers.
2. Is your clinic participating in the GP Partnership/ Shared Care Programme with Restructured Hospitals
(e.g. Delivery on Target (DOT), Mental Health GP Partnership Programme, GP Empowerment Programme)?
1 Yes, please specify the name of the restructured hospital, and type of programme:
Restructured Hospital Type of Programme
a.
b.
c.
2 No
3. Does your clinic provide the following medical services? If your clinic is not providing the service, please share the
reason(s) why.
Yes No
Payable Pro-bono Both If No, why does your clinic not provide the service?
Home medical
services
a. 1 2 3
Medical services for
Nursing Homes
b. 1 2 3
4. Please indicate the number of hours that your clinic is operating in the morning, afternoon, evening and night for each
day of a typical calendar week, and during public holidays (PH). If your clinic is not open for consultation for a
particular time segment, please indicate ‘0’ hours in that segment.
Note: The maximum number of hours in each segment is 6 hours.
PRIMARY CARE SURVEY 2014
- Family Medicine Clinics -
Clinic
ID :
CHAS: Yes / No
CDMP: Yes / No
48
Mon
(in hrs)
Tue
(in hrs)
Wed
(in hrs)
Thu
(in hrs)
Fri
(in hrs)
Sat
(in hrs)
Sun
(in hrs)
PH
(in hrs)
Morning (6.00am to 12.00pm)
Afternoon (12.00pm to 6.00pm)
Evening (6.00pm to 12.00am)
Night (12.00am to 6.00am)
5. Does your clinic provide the following services? If yes, please indicate with a tick whether it is conducted (a) within your
clinic and by whom; and/or (b) outsourced. Please specify which institution(s) the service is outsourced to.
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
I. Diagnostic Test
Doctor Nurse
Allied
Health
a. Blood test for fasting glucose and fasting lipids
1 2 3 4 5
b. On-site Haemoglobin A1c (HbA1c) test
1 2 3 4 5
c. Hepatitis A & B (Adult)
1 2 3 4 5
d. HIV screening
1 2 3 4 5
e. Nephropathy assessment
1 2 3 4 5
f. Pap smear taking
1 2 3 4 5
g. Renal function – creatinine and/or eGFR
1 2 3 4 5
h. Serum cholesterol level (LDL-C) test
1 2 3 4 5
i. Urine dipstick test
1 2 3 4 5
j. Urine protein – urine protein: creatinine ratio
1 2 3 4 5
49
II. Clinical Assessment/ Physical Examination
a. Ankle Brachial Index
1 2 3 4 5
b. Asthma Control Test (ACT)
1 2 3 4 5
c. Clinical thromboembolism risk assessment
1 2 3 4 5
d. Diabetic retinal photography
1 2 3 4 5
e. Elderly functional assessment
1 2 3 4 5
f. Eye assessment
1 2 3 4 5
g. Foot assessment
1 2 3 4 5
h. Hearing test
1 2 3 4 5
i. Smoking cessation programme
1 2 3 4 5
j. Spirometry
1 2 3 4 5
III. Assessment using the following scales:
a. Assessment of memory (MMSE or CMMSE
testing or other validated instruments)
1 2 3 4 5
b. Clinical Global Impression (CGI) Scale
1 2 3 4 5
c. International Prostate Symptom Score (I-PSS)
1 2 3 4 5
d. Schawb and England Activities of Daily Living
Scale
1 2 3 4 5
50
e. Unified Parkinson’s Disease Rating Scale (falls)
1 2 3 4 5
IV. Vaccination
a. Childhood vaccination
1 2 3 4 5
b. Influenza vaccination
1 2 3 4 5
c. Travel Vaccination
1 2 3 4 5
V. Education & Counselling
a. Education & Counselling to promote self-care
1 2 3 4 5
b. Family Planning advice
1 2 3 4 5
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
VI. Allied Health Services
Doctor Nurse
Allied
Health
a. Dietetic counselling services
1 2 3 4 5
b. Occupational therapy services
1 2 3 4 5
c. Physiotherapy services
1 2 3 4 5
d. Podiatry services
1 2 3 4 5
e. Speech therapy services
1 2 3 4 5
51
VII. Procedures
a. Ear syringing
1 2 3 4 5
b. Incision and drainage
1 2 3 4 5
c. Intralesional injection for trigger finger
1 2 3 4 5
d. IUCD insertion and removal
1 2 3 4 5
e. Nail avulsion / Wedge resection
1 2 3 4 5
f. Naso-gastric tube insertion
1 2 3 4 5
g. Relieve of subungal haematoma
1 2 3 4 5
h. Urinary catheterisation
1 2 3 4 5
i. Wound desloughing and removal of foreign body
1 2 3 4 5
j. Wound dressing
1 2 3 4 5
VIII. Other procedure(s) and service(s), please specify:
a.
2 3 4 5
b.
2 3 4 5
c.
2 3 4 5
d.
2 3 4 5
52
e.
2 3 4 5
f.
2 3 4 5
g.
2 3 4 5
h.
2 3 4 5
i.
2 3 4 5
j.
2 3 4 5
53
SECTION B: INFORMATION ON GENERAL PRACTITIONERS, NURSES AND ALLIED HEALTH PROFESSIONALS
6. Please provide the following information for ALL GPs who perform clinical work in your clinic during the survey week.
(Exclude (a) GPs who are doing only administrative work (b) Specialists and (c) Dentists)
S/N of
Doctor
Doctor MCR no.
(Doctor MCR no.
to correspond to
Doctor MCR no.
provided in
Section C)
Resident doctor*1,
Locum doctor*2 Or
Resident/Trainee*3 of Clinic
TICK ONE BOX
Scheduled No.
of Clinical
Hours to work
during the
Survey Week
(in hrs)
Actual No. of Clinical Hours worked on each day of the Survey Week
(in hrs)
Resident
doctor
Locum
doctor
Resident
/Trainee
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
Sun
28 Sep
01. 1
2
3
02. 1
2
3
03. 1
2
3
04. 1
2
3
05. 1
2
3
06. 1
2
3
07. 1
2
3
08. 1
2
3
09. 1
2
3
10. 1
2
3
54
7. Please provide the following information for ALL Nurses who perform clinical work in your clinic during the survey week.
(Exclude Nurses who are doing only administrative work outside of clinical setting.)
S/N of
Nurse
Registered Nurse, Enrolled Nurse,
Advanced Practice Nurse Or Registered
Midwife
TICK ALL THAT APPLIES
Scheduled
No. of Hours
to work on
Survey Day
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Registered
Nurse
Enrolled
Nurse
Advanced
Practice
Nurse Registered
Midwife
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
Sun
28 Sep
01. 1
2
3
4
02. 1
2
3
4
03. 1
2
3
4
04. 1
2
3
4
05. 1
2
3
4
06. 1
2
3
4
07. 1
2
3
4
08. 1
2
3
4
09. 1
2
3
4
10. 1
2
3
4
*1 Resident doctors refer to doctors who are permanently employed in your clinic, including those who work on fixed days in a week or on rotational basis to various clinics.
*2 Locum doctors refer to doctors who are on non-permanent employment, typically called in to supplement/ substitute/ stand in temporarily for the resident doctors.
*3 Residents/Trainees refer to doctors on the residency programme or on training.
55
8. Please provide the following information for ALL Allied Health Professionals (AHPs) who perform clinical work in your clinic during the survey week.
(Exclude AHPs who are doing only administrative work outside of clinical setting.)
S/N of
AHP
Registered Allied Health Professionals
Please fill in the job title in the box below
Scheduled No.
of Hours to
work during
the Survey
Week
(in hrs)
Actual No. of Hours worked on each day of the Survey Week
(in hrs)
Occupational
Therapy*1
(or Ergomedicine or
Ergotherapy)
Physiotherapy*2
Speech-Language
Pathology*3
(Speech Language
Pathology)
Mon
22 Sep
Tue
23 Sep
Wed
24 Sep
Thu
25 Sep
Fri
26 Sep
Sat
27 Sep
Sun
28 Sep
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
*1 Occupational Therapist, Ergotherapist
*2 Physiotherapist, Physical Therapist
*3 Speech Language Therapist (or Speech-Language Therapist), Speech Language Pathologist (or Speech-Language Pathologist), Speech and Language Therapist (or Speech-and-Language
Therapist), Speech and Language Pathologist (or Speech-and-Language Pathologist), Speech Therapist (or Speech-Therapist), Speech Pathologist (or Speech-Pathologist)
56
SECTION C : PATIENT’S PROFILE (To be completed on EACH day of the Survey Week)
SURVEY DAY: D D M M 1 4 Total number of patient seen
Please provide the required information for each patient by writing in the space provided or by ticking � the appropriate box(es).
I. Patient Profile
a. Queue No /Registration No
b. Year of Birth (e.g. 1945, 2001)
c. Sex: 1. Male �1 �1 �1 �1
2. Female �2 �2 �2 �2
d. Race: 1. Chinese �1 �1 �1 �1
2. Malay �2 �2 �2 �2
3. Indian �3 �3 �3 �3
4. Others �4 �4 �4 �4
e. Residential Status: 1. S’pore Citizen/PR (Pink IC/Blue IC) �1 �1 �1 �1
2. Foreigner Working/Living in S’pore (FIN) �2 �2 �2 �2
3. Others �3 �3 �3 �3
f. House Unit No. Pls fill in Unit No. if available. For any address without ‘#”
(S’pore Landed property), pls fill in ‘0’
For patients not living in S’pore, pls fill in ‘999999’ and if
address is unknown, pls fill in ‘888888’
#xx- _______ #xx- _______ #xx- _______ #xx- _______
g. Road Name (Pls specify only for those
living in S’pore Landed Property)
h. Postal Code For patients living in S’pore HDB/Pte Apt/Condo, pls fill in
the 6-digit postal code. For those living in S’pore Landed
Property, pls fill in only the first 2 digits of the 6-digit postal
code. For patients not living in S’pore, pls fill in '999999' and
if address is unknown, pls fill in '888888'
II. Doctor Consult
a. Doctor Serial No. or MCR no. (Please use same S/N or MCR no. as in Section B, Q6)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1
2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
c. Diagnosis (Up to 5)
Principal Diagnosis (PLS INDICATE ONE ONLY)
(Main reason for clinic visit)
Other Diagnosis 1 (PLS INDICATE ONE ONLY)
Other Diagnosis 2 (PLS INDICATE ONE ONLY)
Other Diagnosis 3 (PLS INDICATE ONE ONLY)
Other Diagnosis 4 (PLS INDICATE ONE ONLY)
d. Medical Certificate (MC)
issued? If yes, indicate how
many days.
1. Yes �1 ___ days �1 ___ days �1 ___ days �1 ___ days
2. No �2 �2 �2 �2
III. Nurse Consult
a. Nurse Serial No. (Please use same S/N as in Section B, Q7)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1 2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
c. Procedure 1 (PLS INDICATE ONE ONLY)
Procedure 2 (PLS INDICATE ONE ONLY)
Procedure 3 (PLS INDICATE ONE ONLY)
Procedure 4 (PLS INDICATE ONE ONLY)
For Office Use:
57
Footnotes: *1 CHAS Subsidy: Subsidy for patients who hold the following cards: Blue or Orange Community Health Assist Scheme (CHAS), Pioneer Generation or Public Assistance card(s). *2 Insurance
Company:
Include personal or employer insurance, actual payment made by insurance company.
*3 Company Contract: Amount paid directly by patient’s company. Does not include patients who enjoy corporate rates but are required to pay upfront and seek reimbursement on their
own. *4 MBS@Gov: Amount received from PSD. Does not include cash co-payment made by patients. *5 Baby Bonus CDA: Payment using Baby Bonus Child Development Account. *6 Medisave (Own): Amount withdrawn from patient’s Medisave to pay for approved treatment. *7 Medisave (Family): Amount withdrawn from patient family member’s Medisave to pay for approved treatment. *8 Cash out of Pocket: All payment made in cash by patient. Include patients who are required to pay upfront and seek reimbursement on their own from insurance company/ employer,
and those required to make cash co-payment after other forms of payments have been deducted / subsidies have been applied (i.e. CHAS subsidy, insurance
company and company contract payment, MBS@Gov, Baby Bonus CDA, Medisave).
IV. AHP Consult
a. AHP Serial No. (Please use same S/N as in Section B, Q8)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1
2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
c. Procedure 1 (PLS INDICATE ONE ONLY)
Procedure 2 (PLS INDICATE ONE ONLY)
Procedure 3 (PLS INDICATE ONE ONLY)
Procedure 4 (PLS INDICATE ONE ONLY)
V. Bill and Payment Information
a. Mode of Payment TICK ALL THAT APPLY TICK ALL THAT APPLY TICK ALL THAT APPLY TICK ALL THAT APPLY 1. CHAS Subsidy*1 �1 �1 �1 �1
2. Insurance Company*2 �2 �2 �2 �2
3. Company Contract*3 �3 �3 �3 �3
4. MBS@Gov*4 �4 �4 �4 �4
5. Baby Bonus CDA*5 �5 �5 �5 �5
6. Medisave (Own)*6 �6 �6 �6 �6
7. Medisave (Family)*7 �7 �7 �7 �7
8. Cash out of Pocket *8 �8 �8 �8 �8
b. Bill Size Components [To fill in $ amount of components as
shown in the patient’s bill. The $ amount
should (i) exclude GST; and (ii) before
deduction of any form of payment, waiver
of fees or subsidies]
AMOUNT AMOUNT AMOUNT AMOUNT
1. Consultation Fees $ $ $ $
2. Medication/ Drugs $ $ $ $
3. Laboratory/ Diagnostic Tests $ $ $ $
4. Procedures
(To itemise the procedures if available from
the bill)
$
$
$
$
(i). $ $ $ $
(ii). $ $ $ $
(iii). $ $ $ $
(iv). $ $ $ $
5. Others $ $ $ $ c. Total Bill
[The $ amount should (i) Include GST but (ii)
before deduction of any form of payment,
waiver of fees or subsidies]
$
$
$
$
d. Cash out of Pocket*8 (received by clinic) $ $ $ $
Page of for this clinic
58
A-3: Questionnaire for Private GP Clinics (Non-Medical Group)
For Office Use:
SECTION A: INFORMATION ON GROUP PRACTICE
1. Do you consider your clinic as a group practice?
1 Yes - GO TO Q2
2 No - GO TO Q4
2. Altogether, how many clinics are there in your group, including your own clinic?
clinics
3. Altogether, how many Doctors, Nurses and Allied Health Professionals (AHPS) are there in your group, including your
own clinic?
(Exclude (a) GPs who are Specialists (b) Dentists; and (c) GPs, Nurses and AHPs who are doing only administrative
work.)
Doctors Nurses AHPs
SECTION B: INFORMATION ON CLINIC PRACTICE 4. What is the estimated shortest, longest and average consultation time for acute and chronic cases seen by your clinic
doctors?
5. Is your clinic participating in the GP Partnership/ Shared Care Programme with Restructured Hospitals
(e.g. Delivery on Target (DOT), Mental Health GP Partnership Programme, GP Empowerment Programme)?
Consultation Time Shortest
mins per
case
Longest
mins per
case
Average
mins per
case
a. Acute case refer to cases with short onset such as upper respiratory tract
infections, diarrhoeal diseases, sprains.
b. Chronic case refer to conditions that requires long term follow-up and in
general, regular medications and management of risk factors.
Examples are hypertension, asthma and chronic obstructive
lung disease, diabetes & cancers.
1 Yes, please specify the name of the restructured hospital, and type of programme:
Restructured Hospital Type of Programme
a.
b.
c.
2 No
PRIMARY CARE SURVEY 2014
- Private GP Clinics - Clinic ID :
CHAS: Yes / No
CDMP: Yes / No
59
6. What is the type of patient medical records used by your clinic? (TICK ALL THAT APPLY)
1 Paper Cards
2 Electronic Medical Records using Clinic Management System (CMS) from Clinic Assist
3 Electronic Medical Records using Clinic Management System (CMS) from Medi2000
4 Electronic Medical Records using Clinic Management System (CMS) from Gloco
5 Electronic Medical Records using Other Commercial IT system
(Please specify: )
6 Electronic Medical Records using Freeware/ Shareware/ GP Self-developed Software
7 Others (Please specify: )
7. We would like to obtain feedback from your clinic regarding the use of Electronic Medical Records and IT (Information
Technology) within your clinic. May we seek your consent to provide us with a contact person from your clinic for
participation in such feedback sessions?
The particulars of your clinic and the contact person will be provided to MOH Holdings (MOHH) for follow-up.
1 Yes, my clinic would be willing to participate in the feedback sessions (Please specify name and
telephone of contact person: )
2 No, my clinic would not be willing to participate in the feedback sessions
8. Please indicate the average amount of IT expenditure spent by your clinic during the past 3 years.
(PLEASE INDICATE $0 IF NIL)
Average Amount of IT Expenditure
a. During the past 3 years, how much did your clinic spend on
purchasing new computers and printers on average per
year?
$ per year
b.
During the past 3 years, how much did your clinic spend on
purchasing new software on average per year?
$ per year
c. During the past 3 years, how much did your clinic spend on
IT software subscriptions and IT-related consumables on
average per month?
$ per month
9. Please indicate the name and address of the primary provider that your clinic uses for laboratory services.
Name:
Address: Postal Code:
10. Please indicate the name and address of the primary provider that your clinic uses for radiological services.
Name:
Address: Postal Code:
60
11. Does your clinic provide the following medical services? If yes, please indicate whether payable or pro-bono or both. If
no, please share the reason(s) why.
Yes No
Payabl
e
Pro-
bono Both
If No, why does your clinic not provide the
service?
Home medical
services
a. 1 2 3
Medical services
for
Nursing Homes
b. 1 2 3
12. Does your clinic offer the following aesthetic treatments and procedures? (TICK ALL THAT APPLY)
(Please exclude those offered by Specialists/ Dentists in your clinic)
IF YOUR CLINIC DOES NOT OFFER ANY OF THE FOLLOWING LISTED, PLEASE TICK THE LAST OPTION “None of the above”.
13. In the past one month, what percentage of your clinic’s patient visits is for the aesthetic treatments and procedures
listed in Q12? (PLEASE INDICATE 0% IF NIL)
%
14. Please indicate the number of hours that your clinic is operating in the morning, afternoon, evening and night for each
day of a typical calendar week, and during public holidays (PH). If your clinic is not open for consultation for a
particular time segment, please indicate ‘0’ hours in that segment.
1 Botulinum toxin injection 14 Mechanised massage (e.g. “slidestyler”,
“endermologie” for cellulite treatment)
2 Carboxytherapy 15 Mesotherapy
3 Chemical or pressurized gas/ liquid peels 16 Microdermabrasion
4 Dermabrasion (mechanical) 17 Microneedling dermaroller
5 External Lipolysis (heat/ ultrasound)
18 Negative pressure procedures (e.g.
Vacustyler)
6 Filler injection 19 Photodynamic/ Photopneumatic therapy
7 Free fat grafting 20 Radiofrequency, Infrared and other devices
(e.g. for skin tightening procedures)
8 Hair transplantation 21 Sclerotherapy
9 Intense pulsed light 22 Skin whitening injections
10 Lasers (Ablative e.g. CO2/ YAG) for skin
resurfacing 23 Stem cell treatment (topical/ injections)
11 Lasers (Non-ablative) for hair removal 24 Thread lifts
12 Lasers (vascular lesions, skin
pigmentation and skin rejuvenation) 25 None of the above
13 Liposuction
61
Note: The maximum number of hours in each segment is 6 hours.
Mon
(in hrs)
Tue
(in hrs)
Wed
(in hrs)
Thu
(in hrs)
Fri
(in hrs)
Sat
(in hrs)
Sun
(in hrs)
PH
(in hrs)
Morning (6.00am to 12.00pm)
Afternoon (12.00pm to 6.00pm)
Evening (6.00pm to 12.00am)
Night (12.00am to 6.00am)
15. Does your clinic provide the following services? If yes, please indicate with a tick whether it is conducted (a) within your
clinic and by whom; and/or (b) outsourced. Please specify which institution(s) the service is outsourced to.
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
I. Diagnostic Test
Doctor Nurse
Allied
Health
a. Blood test for fasting glucose and fasting lipids
1 2 3 4 5
b. On-site Haemoglobin A1c (HbA1c) test
1 2 3 4 5
c. Hepatitis A & B (Adult)
1 2 3 4 5
d. HIV screening
1 2 3 4 5
e. Nephropathy assessment
1 2 3 4 5
f. Pap smear taking
1 2 3 4 5
g. Renal function – creatinine and/or eGFR
1 2 3 4 5
h. Serum cholesterol level (LDL-C) test
1 2 3 4 5
i. Urine dipstick test
1 2 3 4 5
62
j. Urine protein – urine protein: creatinine ratio
1 2 3 4 5
II. Clinical Assessment/ Physical Examination
a. Ankle Brachial Index
1 2 3 4 5
b. Asthma Control Test (ACT)
1 2 3 4 5
c. Clinical thromboembolism risk assessment
1 2 3 4 5
d. Diabetic retinal photography
1 2 3 4 5
e. Elderly functional assessment
1 2 3 4 5
f. Eye assessment
1 2 3 4 5
g. Foot assessment
1 2 3 4 5
h. Hearing test
1 2 3 4 5
i. Smoking cessation programme
1 2 3 4 5
j. Spirometry
1 2 3 4 5
III. Assessment using the following scales:
a. Assessment of memory (MMSE or CMMSE
testing or other validated instruments)
1 2 3 4 5
b. Clinical Global Impression (CGI) Scale
1 2 3 4 5
c. International Prostate Symptom Score (I-PSS)
1 2 3 4 5
63
d. Schawb and England Activities of Daily Living
Scale
1 2 3 4 5
e. Unified Parkinson’s Disease Rating Scale (falls)
1 2 3 4 5
IV. Vaccination
a. Childhood vaccination
1 2 3 4 5
b. Influenza vaccination
1 2 3 4 5
c. Travel Vaccination
1 2 3 4 5
V. Education & Counselling
a. Education & Counselling to promote self-care
1 2 3 4 5
b. Family Planning advice
1 2 3 4 5
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
VI. Allied Health Services
Doctor Nurse
Allied
Health
a. Dietetic counselling services
1 2 3 4 5
b. Occupational therapy services
1 2 3 4 5
c. Physiotherapy services
1 2 3 4 5
d. Podiatry services
1 2 3 4 5
64
e. Speech therapy services
1 2 3 4 5
VII. Procedures
a. Ear syringing
1 2 3 4 5
b. Incision and drainage
1 2 3 4 5
c. Intralesional injection for trigger finger
1 2 3 4 5
d. IUCD insertion and removal
1 2 3 4 5
e. Nail avulsion / Wedge resection
1 2 3 4 5
f. Naso-gastric tube insertion
1 2 3 4 5
g. Relieve of subungal haematoma
1 2 3 4 5
h. Urinary catheterisation
1 2 3 4 5
i. Wound desloughing and removal of foreign body
1 2 3 4 5
j. Wound dressing
1 2 3 4 5
VIII. Other procedure(s) and service(s), please specify:
a.
2 3 4 5
b.
2 3 4 5
c.
2 3 4 5
65
d.
2 3 4 5
e.
2 3 4 5
f.
2 3 4 5
g.
2 3 4 5
h.
2 3 4 5
i.
2 3 4 5
j.
2 3 4 5
66
16. Please provide the following information for ALL GPs who perform clinical work in your clinic on the survey day.
(Exclude (a) GPs who are doing only administrative work (b) Specialists and (c) Dentists)
S/N of
Doctor
Doctor MCR no.
(Doctor MCR no. to
correspond to Doctor
MCR no. provided in
Section C)
Resident doctor*1
Or Locum doctor*2
of Clinic
TICK ONE BOX
Scheduled No. of
Clinical Hours to
work on Survey Day
(in hrs)
Actual No. of Clinical
Hours worked on
Survey Day
(in hrs) Resident
Doctor
Locum
Doctor
01.
1 2
02.
1 2
03.
1 2
04.
1 2
05.
1 2
06.
1 2
07.
1 2
08.
1 2
09.
1 2
10.
1 2
11.
1 2
12.
1 2
13.
1 2
14.
1 2
15.
1 2
rs
*1 Resident doctors refer to doctors who are permanently employed in your clinic, including those who
work on fixed days in a week or on rotational basis to other clinics.
*2 Locum doctors refer to doctors who are on non-permanent employment, typically called in to
supplement/ substitute/ stand in temporarily for the resident doctors.
67
17. Please provide the following information for ALL Nurses who perform clinical work in your clinic on the survey day.
(Exclude Nurses who are doing only administrative work outside of clinical setting.)
S/N of
Nurse
(To be
used in
Section C)
Registered Nurse, Enrolled Nurse,
Advanced Practice Nurse Or Registered Midwife
TICK ALL THAT APPLIES
Scheduled No. of
Hours to work on
Survey Day
(in hrs)
Actual No. of Hours
worked on Survey
Day
(in hrs) Registered
Nurse
Enrolled
Nurse
Advanced
Practice
Nurse
Registered
Midwife
01. 1 2
3
4
02. 1 2
3 4
03. 1 2
3 4
04. 1 2
3 4
05. 1 2
3
4
06. 1 2
3
4
07. 1 2
3 4
08. 1 2
3 4
09. 1 2
3 4
10. 1 2
3
4
11. 1 2
3
4
12. 1 2
3 4
13. 1 2
3 4
14. 1 2
3 4
15. 1 2
3
4
68
18. Please provide the following information for ALL Allied Health Professionals (AHPs) who perform clinical work in your
clinic on the survey day. (Exclude AHPs who are doing only administrative work outside of clinical setting.)
S/N of
Allied Health
Professional
(To be
used in
Section C)
Registered Allied Health Professionals
Please fill in the job title in the box below Scheduled No.
of Hours to
work on
Survey Day
(in hrs)
Actual No. of
Hours worked
on Survey Day
(in hrs) Occupational
Therapy*1
(or Ergomedicine or
Ergotherapy)
Physiotherapy*2
Speech-Language
Pathology*3
(Speech Language
Pathology)
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
*1 Occupational Therapist, Ergotherapist
*2 Physiotherapist, Physical Therapist
*3 Speech Language Therapist (or Speech-Language Therapist), Speech Language Pathologist (or Speech-Language
Pathologist), Speech and Language Therapist (or Speech-and-Language Therapist), Speech and Language Pathologist
(or Speech-and-Language Pathologist), Speech Therapist (or Speech-Therapist), Speech Pathologist (or Speech-
Pathologist)
69
SECTION C : PATIENT’S PROFILE (To be completed on Survey Day)
SURVEY DAY: D D M M 1 4 Total number of patient seen
Please provide the required information for each patient by writing in the space provided or by ticking � the appropriate
box(es).
I. Patient Profile
a. Queue No /Registration No
b. Year of Birth (e.g. 1945, 2001)
c. Sex: 1. Male �1 �1 �1 �1
2. Female �2 �2 �2 �2
d. Race: 1. Chinese �1 �1 �1 �1
2. Malay �2 �2 �2 �2
3. Indian �3 �3 �3 �3
4. Others �4 �4 �4 �4
e. Residential Status:
1. S’pore Citizen/PR (Pink IC/Blue IC) �1 �1 �1 �1
2. Foreigner Working/Living in S’pore (FIN) �2 �2 �2 �2
3. Others �3 �3 �3 �3
f. House Unit No. Pls fill in Unit No. if available. For any address without ‘#”
(S’pore Landed property), pls fill in ‘0’
For patients not living in S’pore, pls fill in ‘999999’ and if
address is unknown, pls fill in ‘888888’
#xx- _______ #xx- _______ #xx- _______ #xx- _______
g. Road Name (Pls specify only for those
living in S’pore Landed Property)
h. Postal Code For patients living in S’pore HDB/Pte Apt/Condo, pls fill in
the 6-digit postal code. For those living in S’pore Landed
Property, pls fill in only the first 2 digits of the 6-digit postal
code. For patients not living in S’pore, pls fill in '999999' and
if address is unknown, pls fill in '888888'
II. Doctor Consult
a. Doctor Serial No. or MCR no. (Please use same S/N or MCR no. as in Section B, Q16)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1
2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
c. Diagnosis (Up to 5)
Principal Diagnosis (PLS INDICATE ONE ONLY)
(Main reason for clinic visit)
Other Diagnosis 1 (PLS INDICATE ONE ONLY)
Other Diagnosis 2 (PLS INDICATE ONE ONLY)
Other Diagnosis 3 (PLS INDICATE ONE ONLY)
Other Diagnosis 4 (PLS INDICATE ONE ONLY)
d. Medical Certificate (MC)
issued? If yes, indicate how
many days.
1. Yes �1 ___ days �1 ___ days �1 ___ days �1 ___ days
2. No �2 �2 �2 �2
III. Nurse Consult
a. Nurse Serial No. (Please use same S/N as in Section B, Q17)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1
2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
For Office Use:
70
c. Procedure 1 (PLS INDICATE ONE ONLY)
Procedure 2 (PLS INDICATE ONE ONLY)
Procedure 3 (PLS INDICATE ONE ONLY)
Procedure 4 (PLS INDICATE ONE ONLY)
71
Footnotes: *1 CHAS Subsidy: Subsidy for patients who hold the following cards: Blue or Orange Community Health Assist Scheme (CHAS), Pioneer Generation or Public Assistance card(s). *2 Insurance Company: Include personal or employer insurance, actual payment made by insurance company. *3 Company Contract: Amount paid directly by patient’s company. Does not include patients who enjoy corporate rates but are required to pay upfront and seek reimbursement on their own. *4 MBS@Gov: Amount received from PSD. Does not include cash co-payment made by patients. *5 Baby Bonus CDA: Payment using Baby Bonus Child Development Account. *6 Medisave (Own): Amount withdrawn from patient’s Medisave to pay for approved treatment. *7 Medisave (Family): Amount withdrawn from patient family member’s Medisave to pay for approved treatment. *8 Cash out of Pocket: All payment made in cash by patient. Include patients who are required to pay upfront and seek reimbursement on their own from insurance company/ employer, and
those required to make cash co-payment after other forms of payments have been deducted / subsidies have been applied (i.e. CHAS subsidy, insurance company and
company contract payment, MBS@Gov, Baby Bonus CDA, Medisave).
IV. AHP Consult
a. AHP Serial No. (Please use same S/N as in Section B, Q18)
b. Consultation Time Segment SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION SELECT ONE OPTION
1. Morning (6.00am to 12.00pm) �1 �1 �1 �1
2. Afternoon (12.00pm to 6.00pm) �2 �2 �2 �2
3. Evening (6.00pm to 12.00am) �3 �3 �3 �3
4. Night (12.00am to 6.00am) �4 �4 �4 �4
c. Procedure 1 (PLS INDICATE ONE ONLY)
Procedure 2 (PLS INDICATE ONE ONLY)
Procedure 3 (PLS INDICATE ONE ONLY)
Procedure 4 (PLS INDICATE ONE ONLY)
V. Bill and Payment Information
a. Mode of Payment TICK ALL THAT APPLY TICK ALL THAT APPLY TICK ALL THAT APPLY TICK ALL THAT APPLY 1. CHAS Subsidy*1 �1 �1 �1 �1
2. Insurance Company*2 �2 �2 �2 �2
3. Company Contract*3 �3 �3 �3 �3
4. MBS@Gov*4 �4 �4 �4 �4
5. Baby Bonus CDA*5 �5 �5 �5 �5
6. Medisave (Own)*6 �6 �6 �6 �6
7. Medisave (Family)*7 �7 �7 �7 �7
8. Cash out of Pocket*8 �8 �8 �8 �8
b. Bill Size Components [To fill in $ amount of components as shown
in the patient’s bill. The $ amount should (i)
exclude GST; and (ii) before deduction of any
form of payment, waiver of fees or subsidies]
AMOUNT AMOUNT AMOUNT AMOUNT
1. Consultation Fees $ $ $ $
2. Medication/ Drugs $ $ $ $ 3. Laboratory/ Diagnostic Tests $ $ $ $
4. Procedures
(To itemise the procedures if available from
the bill)
$
$
$
$
(i). $ $ $ $
(ii). $ $ $ $
(iii). $ $ $ $
(iv). $ $ $ $
5. Others $ $ $ $
c. Total Bill
[The $ amount should (i) Include GST but (ii)
before deduction of any form of payment,
waiver of fees or subsidies]
$
$
$
$
d. Cash out of Pocket*8 (received by clinic) $ $ $ $
Page of for this clinic
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A-4: Questionnaire for Private GP Medical Groups
For Office Use:
Name of Clinic :
Address of Clinic :
SECTION A: INFORMATION ON GROUP PRACTICE
1. Do you consider your clinic as a group practice?
1 Yes - GO TO Q2
2 No - GO TO Q4
2. Altogether, how many clinics are there in your group, including your own clinic?
clinics
3. Altogether, how many Doctors, Nurses and Allied Health Professionals (AHPS) are there in your group,
including your own clinic?
(Exclude (a) GPs who are Specialists (b) Dentists; and (c) GPs, Nurses and AHPs who are doing only
administrative work.)
Doctors Nurses AHPs
SECTION B: INFORMATION ON CLINIC PRACTICE
4. What is the estimated shortest, longest and average consultation time for acute and chronic cases seen by
your clinic doctors?
Consultation Time Shortest
mins per
case
Longest
mins per
case
Average
mins per
case a. Acute case
refer to cases with short onset such as upper respiratory tract infections,
diarrhoeal diseases, sprains.
b. Chronic case
refer to conditions that requires long term follow-up and in general,
regular medications and management of risk factors. Examples are
hypertension, asthma and chronic obstructive lung disease, diabetes &
cancers.
5. Is your clinic participating in the GP Partnership/ Shared Care Programme with Restructured Hospitals
(e.g. Delivery on Target (DOT), Mental Health GP Partnership Programme, GP Empowerment Programme)?
PRIMARY CARE SURVEY 2014
- Private GP Medical Groups - Clinic ID :
CHAS: Yes / No
CDMP: Yes / No
73
1 Yes, please specify the name of the restructured hospital, and type of programme:
Restructured Hospital Type of Programme
a.
b.
c.
2 No
6. What is the type of patient medical records used by your clinic? (TICK ALL THAT APPLY)
1 Paper Cards
2 Electronic Medical Records using Clinic Management System (CMS) from Clinic Assist
3 Electronic Medical Records using Clinic Management System (CMS) from Medi2000
4 Electronic Medical Records using Clinic Management System (CMS) from Gloco
5 Electronic Medical Records using Other Commercial IT system
(Please specify: )
6 Electronic Medical Records using Freeware/ Shareware/ GP Self-developed Software
7 Others (Please specify: )
7. We would like to obtain feedback from your clinic regarding the use of Electronic Medical Records and IT
(Information Technology) within your clinic. May we seek your consent to provide us with a contact person
from your clinic for participation in such feedback sessions?
The particulars of your clinic and the contact person will be provided to MOH Holdings (MOHH) for follow-up.
1 Yes, my clinic would be willing to participate in the feedback sessions (Please specify name and
telephone of contact person: )
2 No, my clinic would not be willing to participate in the feedback sessions
8. Please indicate the average amount of IT expenditure spent by your clinic during the past 3 years.
(PLEASE INDICATE $0 IF NIL)
Average Amount of IT Expenditure
a. During the past 3 years, how much did your clinic spend on
purchasing new computers and printers on average per year?
$ per year
b.
During the past 3 years, how much did your clinic spend on
purchasing new software on average per year?
$ per year
c. During the past 3 years, how much did your clinic spend on IT
software subscriptions and IT-related consumables on
average per month?
$ per month
74
9. Please indicate the name and address of the primary provider that your clinic uses for laboratory services.
Name:
Address: Postal Code:
10. Please indicate the name and address of the primary provider that your clinic uses for radiological services.
Name:
Address: Postal Code:
11. Does your clinic provide the following medical services? If yes, please indicate whether payable or pro-bono or
both. If no, please share the reason(s) why.
Yes No
Payable Pro-bono Both If No, why does your clinic not provide the service?
Home medical
services
a. 1 2 3
Medical services for
Nursing Homes
b. 1 2 3
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12. Does your clinic offer the following aesthetic treatments and procedures? (TICK ALL THAT APPLY)
(Please exclude those offered by Specialists/ Dentists in your clinic)
IF YOUR CLINIC DOES NOT OFFER ANY OF THE FOLLOWING LISTED, PLEASE TICK THE LAST OPTION “None of the above”.
1 Botulinum toxin injection 14 Mechanised massage (e.g. “slidestyler”,
“endermologie” for cellulite treatment)
2 Carboxytherapy 15 Mesotherapy
3 Chemical or pressurized gas/ liquid peels 16 Microdermabrasion
4 Dermabrasion (mechanical) 17 Microneedling dermaroller
5 External Lipolysis (heat/ ultrasound) 18 Negative pressure procedures (e.g. Vacustyler)
6 Filler injection 19 Photodynamic/ Photopneumatic therapy
7 Free fat grafting 20 Radiofrequency, Infrared and other devices
(e.g. for skin tightening procedures)
8 Hair transplantation 21 Sclerotherapy
9 Intense pulsed light 22 Skin whitening injections
10 Lasers (Ablative e.g. CO2/ YAG) for skin
resurfacing 23 Stem cell treatment (topical/ injections)
11 Lasers (Non-ablative) for hair removal 24 Thread lifts
12 Lasers (vascular lesions, skin
pigmentation and skin rejuvenation) 25 None of the above
13 Liposuction
13. In the past one month, what percentage of your clinic’s patient visits is for the aesthetic treatments and
procedures listed in Q12? (PLEASE INDICATE 0% IF NIL)
%
14. Please indicate the number of hours that your clinic is operating in the morning, afternoon, evening and night
for each day of a typical calendar week, and during public holidays (PH). If your clinic is not open for
consultation for a particular time segment, please indicate ‘0’ hours in that segment.
Note: The maximum number of hours in each segment is 6 hours.
Mon
(in hrs)
Tue
(in hrs)
Wed
(in hrs)
Thu
(in hrs)
Fri
(in hrs)
Sat
(in hrs)
Sun
(in hrs)
PH
(in hrs)
Morning (6.00am to 12.00pm)
Afternoon (12.00pm to 6.00pm)
Evening (6.00pm to 12.00am)
Night (12.00am to 6.00am)
76
15. Does your clinic provide the following services? If yes, please indicate with a tick whether it is conducted (a) within
your clinic and by whom; and/or (b) outsourced. Please specify which institution(s) the service is outsourced to. No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
I. Diagnostic Test
Doctor Nurse
Allied
Health
a. Blood test for fasting glucose and fasting lipids
1 2 3 4 5
b. On-site Haemoglobin A1c (HbA1c) test
1 2 3 4 5
c. Hepatitis A & B (Adult)
1 2 3 4 5
d. HIV screening
1 2 3 4 5
e. Nephropathy assessment
1 2 3 4 5
f. Pap smear taking
1 2 3 4 5
g. Renal function – creatinine and/or eGFR
1 2 3 4 5
h. Serum cholesterol level (LDL-C) test
1 2 3 4 5
i. Urine dipstick test
1 2 3 4 5
j. Urine protein – urine protein: creatinine ratio
1 2 3 4 5
II. Clinical Assessment/ Physical Examination
a. Ankle Brachial Index
1 2 3 4 5
77
b. Asthma Control Test (ACT)
1 2 3 4 5
c. Clinical thromboembolism risk assessment
1 2 3 4 5
d. Diabetic retinal photography
1 2 3 4 5
e. Elderly functional assessment
1 2 3 4 5
f. Eye assessment
1 2 3 4 5
g. Foot assessment
1 2 3 4 5
h. Hearing test
1 2 3 4 5
i. Smoking cessation programme
1 2 3 4 5
j. Spirometry
1 2 3 4 5
III. Assessment using the following scales:
a. Assessment of memory (MMSE or CMMSE
testing or other validated instruments)
1 2 3 4 5
b. Clinical Global Impression (CGI) Scale
1 2 3 4 5
c. International Prostate Symptom Score (I-PSS)
1 2 3 4 5
d. Schawb and England Activities of Daily Living
Scale
1 2 3 4 5
78
e. Unified Parkinson’s Disease Rating Scale (falls)
1 2 3 4 5
IV. Vaccination
a. Childhood vaccination
1 2 3 4 5
b. Influenza vaccination
1 2 3 4 5
c. Travel Vaccination
1 2 3 4 5
V. Education & Counselling
a. Education & Counselling to promote self-care
1 2 3 4 5
b. Family Planning advice
1 2 3 4 5
No Yes, Within clinic
(Where procedures involve
more than 1 professional,
please tick all that applies)
Yes, Outsourced
[Please specify the institution(s)]
VI. Allied Health Services
Doctor Nurse
Allied
Health
a. Dietetic counselling services
1 2 3 4 5
b. Occupational therapy services
1 2 3 4 5
c. Physiotherapy services
1 2 3 4 5
d. Podiatry services
1 2 3 4 5
e. Speech therapy services
1 2 3 4 5
79
VII. Procedures
a. Ear syringing
1 2 3 4 5
b. Incision and drainage
1 2 3 4 5
c. Intralesional injection for trigger finger
1 2 3 4 5
d. IUCD insertion and removal
1 2 3 4 5
e. Nail avulsion / Wedge resection
1 2 3 4 5
f. Naso-gastric tube insertion
1 2 3 4 5
g. Relieve of subungal haematoma
1 2 3 4 5
h. Urinary catheterisation
1 2 3 4 5
i. Wound desloughing and removal of foreign body
1 2 3 4 5
j. Wound dressing
1 2 3 4 5
VIII. Other procedure(s) and service(s), please specify:
a.
2 3 4 5
b.
2 3 4 5
c.
2 3 4 5
80
d.
2 3 4 5
e.
2 3 4 5
f.
2 3 4 5
g.
2 3 4 5
h.
2 3 4 5
i.
2 3 4 5
j.
2 3 4 5
81
16. Please provide the following information for ALL GPs who perform clinical work in your clinic on the survey day.
(Exclude (a) GPs who are doing only administrative work (b) Specialists and (c) Dentists)
S/N of
Doctor
Doctor MCR no.
(Doctor MCR no. to
correspond to Doctor
MCR no. provided in
Section C)
Resident doctor*1
Or Locum doctor*2
of Clinic
TICK ONE BOX
Scheduled No. of
Clinical Hours to
work on Survey Day
(in hrs)
Actual No. of Clinical
Hours worked on
Survey Day
(in hrs) Resident
Doctor
Locum
Doctor
01.
1 2
02.
1 2
03.
1 2
04.
1 2
05.
1 2
06.
1 2
07.
1 2
08.
1 2
09.
1 2
10.
1 2
11.
1 2
12.
1 2
13.
1 2
14.
1 2
15.
1 2
rs
*1 Resident doctors refer to doctors who are permanently employed in your clinic, including those who
work on fixed days in a week or on rotational basis to various clinics in the same group.
*2 Locum doctors refer to doctors who are on non-permanent employment, typically called in to
supplement/ substitute/ stand in temporarily for the resident doctors.
82
17. Please provide the following information for ALL Nurses who perform clinical work in your clinic on the survey
day. (Exclude Nurses who are doing only administrative work outside of clinical setting.)
S/N of
Nurse
(To be
used in
Section C)
Registered Nurse, Enrolled Nurse,
Advanced Practice Nurse Or Registered Midwife
TICK ALL THAT APPLIES
Scheduled No. of
Hours to work on
Survey Day
(in hrs)
Actual No. of Hours
worked on Survey
Day
(in hrs) Registered
Nurse
Enrolled
Nurse
Advanced
Practice
Nurse
Registered
Midwife
01. 1 2
3 4
02. 1 2
3 4
03. 1 2
3 4
04. 1 2
3 4
05. 1 2
3 4
06. 1 2
3
4
07. 1 2
3
4
08. 1 2
3 4
09. 1 2
3
4
10. 1 2
3 4
11. 1 2
3 4
12. 1 2
3
4
13. 1 2
3
4
14. 1 2
3 4
15. 1 2
3 4
83
18. Please provide the following information for ALL Allied Health Professionals (AHPs) who perform clinical work
in your clinic on the survey day. (Exclude AHPs who are doing only administrative work outside of clinical
setting.)
S/N of
Allied Health
Professional
(To be
used in
Section C)
Registered Allied Health Professionals
Please fill in the job title in the box below Scheduled
No. of Hours
to work on
Survey Day
(in hrs)
Actual No. of
Hours worked
on Survey Day
(in hrs) Occupational
Therapy*1
(or Ergomedicine or
Ergotherapy)
Physiotherapy*2
Speech-Language
Pathology*3
(Speech Language
Pathology)
01.
02.
03.
04.
05.
06.
07.
08.
09.
10.
*1 Occupational Therapist, Ergotherapist
*2 Physiotherapist, Physical Therapist
*3 Speech Language Therapist (or Speech-Language Therapist), Speech Language Pathologist (or Speech-Language
Pathologist), Speech and Language Therapist (or Speech-and-Language Therapist), Speech and Language
Pathologist (or Speech-and-Language Pathologist), Speech Therapist (or Speech-Therapist), Speech Pathologist
(or Speech-Pathologist)
84
SECTION C: PATIENTS’ PROFILE
1. For Section C, please provide the following information listed below for all patients who visit your clinic on the designated survey
day in softcopy Excel format. Please include patients seen by GPs, Nurses and Allied Health Professionals in your clinic but exclude
patients seen by Specialists and Dentists. The explanations on the data items required and the codes to be used are provided below.
For e.g. for Race, the codes to be used are: 1=Chinese, 2=Malay, 3=Indian, 4= Others, 8=Unknown.
2. Please provide the information in accordance to the sequence specified below.
Data Items Required Explanations/ Code To Use
a. Date of Survey Please provide the date in DDMMYYYY format e.g. 22092014
b. Name of Clinic Please provide name of clinic e.g. ABC Clinic
c. Address of Clinic Please provide address of clinic e.g. 123, ABC Road, #05-06
d. Postal Code of Clinic Please provide postal code of clinic e.g. 654123
I. Patient Profile
a. Queue No / Registration No Please provide Queue No / Registration No. of patient (This number
uniquely identifies the patient. Please do not provide patient's NRIC)
b. Year of Birth This is a 4-digit field e.g. 1945, 2001
c. Sex 1=Male
2=Female
8=Unknown
d. Race 1=Chinese
2=Malay
3=Indian
4=Others
8=Unknown
e. Residential Status 1=Singapore Citizen/PR (i.e. patients with NRIC starting with S or T)
2=Foreigner Working/Living in Singapore (i.e. patients with FIN starting
with F or G)
3=Others
8=Unknown
f. House Unit Number
(#xx-___ )
Pls fill in Unit No. if available. For any address without ‘#” (S’pore Landed
property), pls fill in ‘0’
For patients not living in S’pore, pls fill in ‘999999’ and if address is
unknown, pls fill in ‘888888’
g. Road Name Pls specify only for those living in S’pore Landed Property
h. Postal Code For patients living in S’pore HDB/Pte Apt/Condo, please fill in the 6-digit
postal code.
For those living in S’pore Landed Property, please fill in only the first 2
digits of the 6-digit postal code.
For patients not living in Singapore, please fill in '999999' and if address is
unknown, please fill in '888888'
II. Doctor Consult
a. Doctor Serial No. or MCR no.
(Please use same MCR no. as in Section B, Q16)
Please provide Doctor Code (This code uniquely identifies the doctor
e.g. MCR No, System Generated Doctor Code)
b. Doctor Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
85
c. Doctor Diagnosis (Up to 5)
Doctor Principal Diagnosis Code Please provide Principal Diagnosis and Principal Diagnosis Code
Doctor Other Diagnosis 1 Code Please provide Other Diagnosis 1 and Other Diagnosis 1 Code
Doctor Other Diagnosis 2 Code Please provide Other Diagnosis 2 and Other Diagnosis 2 Code
Doctor Other Diagnosis 3 Code Please provide Other Diagnosis 3 and Other Diagnosis 3 Code
Doctor Other Diagnosis 4 Code Please provide Other Diagnosis 4 and Other Diagnosis 4 Code
Data Items Required Explanations/ Code To Use
d. Medical Certificate (MC) issued? 1=Yes 2=No
If yes, how many days? No. of days
III. Nurse Consult
a. Nurse Serial No.
(Please use same S/N no. as in Section B, Q17)
Please provide Nurse Code
b. Nurse Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
c. Nurse Procedures (Up to 4)
Nurse Procedure 1 Please provide Procedure 1
Nurse Procedure 2 Please provide Procedure 2
Nurse Procedure 3 Please provide Procedure 3
Nurse Procedure 4 Please provide Procedure 4
IV. AHP Consult
a. AHP Serial No.
(Please use same S/N no. as in Section B, Q18)
Please provide AHP Code
b. AHP Consultation Time Segment 1=Morning (6.00am to 12.00pm)
2=Afternoon (12.00pm to 6.00pm)
3=Evening (6.00pm to 12.00am)
4=Night (12.00am to 6.00am)
c. AHP Procedures (Up to 4)
AHP Procedure 1 Please provide Procedure 1
AHP Procedure 2 Please provide Procedure 2
AHP Procedure 3 Please provide Procedure 3
AHP Procedure 4 Please provide Procedure 4
V. Bill and Payment Information
a. Mode of Payment
1. CHAS Subsidy*1 1=Yes 2=No
2. Insurance Company*2 1=Yes 2=No 3. Company Contract*3 1=Yes 2=No 4. MBS@Gov*4 1=Yes 2=No 5. Baby Bonus CDA*5 1=Yes 2=No 6. Medisave (Own)*6 1=Yes 2=No 7. Medisave (Family)*7 1=Yes 2=No
8. Cash out of Pocket *8 1=Yes 2=No
b. Bill Size Components
[To fill in $ amount of components as shown in the patient’s
bill. The $ amount should (i) exclude GST; and (ii) before
deduction of any form of payment, waiver of fees or
subsidies]
1. Consultation Fees $
2. Medication/ Drugs $
86
3. Laboratory/ Diagnostic Tests $
4. Procedures
(To itemise the procedures if available from the bill)
$
i. $
ii. $
iii. $
iv. $
5. Others $
c. Total Bill
[The $ amount should (i) Include GST but (ii) before
deduction of any form of payment, waiver of fees or
subsidies]
$
d. Cash out of Pocket*8 (received by clinic) $
Footnotes:
*1 CHAS Subsidy: Subsidy for patients who hold the following cards: Blue or Orange Community Health Assist Scheme
(CHAS), Pioneer Generation or Public Assistance card(s). *2 Insurance Company: Include personal or employer insurance, actual payment made by insurance company.
*3 Company Contract: Amount paid directly by patient’s company. Does not include patients who enjoy corporate rates but
are required to pay upfront and seek reimbursement on their own.
*4 MBS@Gov: Amount received from PSD. Does not include cash co-payment made by patients.
*5 Baby Bonus CDA: Payment using Baby Bonus Child Development Account.
*6 Medisave (Own): Amount withdrawn from patient’s Medisave to pay for approved treatment.
*7 Medisave (Family): Amount withdrawn from patient family member’s Medisave to pay for approved treatment.
*8 Cash out of Pocket: All payment made in cash by patient. Include patients who are required to pay upfront and seek
reimbursement on their own from insurance company/ employer, and those required to make cash
co-payment after other forms of payments have been deducted / subsidies have been applied (i.e.
CHAS subsidy, insurance company and company contract payment, MBS@Gov, Baby Bonus CDA,
Medisave).
87
Ministry of Health College of Medicine Building
16 College Road
Singapore 169854
http://www.moh.gov.sg